Immediately restored single implants in the aesthetic zone of the maxilla using a novel design: 5‐year results from a prospective single‐arm clinical trial

Abstract

Background Single implant crowns have become the preferred rehabilitation treatment option for replacing a missing tooth. Purpose This study evaluates 5‐year clinical success of using tilted implants placed immediately after extraction followed by rehabilitation with all‐ceramic crowns. Materials and Methods Twenty‐seven participants requiring 28 single implant crowns in the aesthetic zone of maxilla were recruited to participate in a single‐arm clinical trial. All participants were rehabilitated according to immediate implant placement using CP grade 4 titanium implants with roughened surfaces and a 12°‐angled platform. Provisional implant crowns were connected within 4 hours of implant placement and loaded according to progressive loading protocol. At 8 weeks (baseline), definitive screw‐retained crowns fabricated using densely sintered zirconia abutments with the veneering porcelain were delivered. Participants were followed up to 5 years and 16 participants with 17 single implant crowns attended Year 5 recall. Data collection included changes in marginal bone levels (MBLs), mid‐buccal mucosal levels (MBMLs), implant stability quotient (ISQ) values, and any prosthodontic maintenance issues. Results The mean changes in MBLs at each recall was bone fill of 0.5 ± 1.18 mm (surgery—baseline), increase of 0.1 ± 0.57 mm (baseline—Year 1), and marginal bone loss of 0.1 ± 0.25 mm (Years 1‐5). A minimal change occurred with the MBMLs during the observation period. The mean ISQ value at each time point increased from 65.1 (implant placement), to 67.4 (baseline) and 69.9 (Years 1 and 5). Prosthodontic maintenance issues occurred only during the first year which included fracture of veneering ceramic and zirconia abutment as well as aesthetic concerns. Conclusions Within the limitations of this study, the data collected would suggest that replacing a single missing tooth using titanium oral implants with 12° platform tilt and zirconia abutments can be a successful rehabilitation option in the esthetically demanding zone of anterior maxilla.

When to save or remove implants in the smile zone: A clinical report of maxillary lateral incisor implants in malposition

“…This allows for the potential for a screw-retained final restoration but must be planned prior to implant placement since it is a surgical decision that effects the restorative outcome. 16,17…”

“…The amount of correction afforded ranges from 12 to 36° depending upon the clinical situation required. This allows for the potential for a screw‐retained final restoration but must be planned prior to implant placement since it is a surgical decision that effects the restorative outcome 16,17 …”

Implants Placement in Contact with Dental Tissue: A Potential Paradigm Shift? Systematic Literature Review

“…1 Among these changes, implant connection, one-time surgery, and immediate loading could be cited. 2 3 The only common concept that has not been changed is the concept of osteointergration, where the implant surface is intimately covered with bone. However, in some clinical situations particularly when the teeth are impacted, it seems critical to indicate implants.…”

Managing restorative space, color matching, and tooth replacement with a novel implant through interdisciplinary treatment: A case report of partial anodontia and malformed teeth in the esthetic zone

“…In addition, diameter is more effective than length in soft quality bone and becomes more significant in implant survival when provisional or final restorations are provided in treatment 21,22 . Another feature of the implant design was a 12° subcrestal angle correction of the implant‐abutment interface to allow screw‐retention vs cementation and the associated periodontal problems of cement remnants in the periimplant tissues 23‐25 . This allows the surgeon to place the implant “where the bone is” and following the natural anatomy of the ridge or socket, without compromises to delivery of a screw‐retained restoration 26‐29 .…”

“…21,22 Another feature of the implant design was a 12 subcrestal angle correction of the implant-abutment interface to allow screw-retention vs cementation and the associated periodontal problems of cement remnants in the periimplant tissues. [23][24][25] This allows the surgeon to place the implant "where the bone is" and following the natural anatomy of the ridge or socket, without compromises to delivery of a screwretained restoration. [26][27][28][29] The implants are delivered with a preconnected mount or carrier with orientation and depth laser markings.…”