Hard and soft tissue changes after crestal and subcrestal immediate implant placement

Background: The purpose of this study is to assess the influence of the placement level of implants with a laser‐microtextured collar design on the outcomes of crestal bone and soft tissue levels. In addition, we assessed the vertical and horizontal defect fill and identified factors that influenced clinical outcomes of immediate implant placement. Methods: Twenty‐four patients, each with a hopeless tooth (anterior or premolar region), were recruited to receive dental implants. Patients were randomly assigned to have the implant placed at the palatal crest or 1 mm subcrestally. Clinical parameters including the keratinized gingival (KG) width, KG thickness, horizontal defect depth (HDD), facial and interproximal marginal bone levels (MBLs), facial threads exposed, tissue–implant horizontal distance, gingival index (GI), and plaque index (PI) were assessed at baseline and 4 months after surgery. In addition, soft tissue profile measurements including the papilla index, papilla height (PH), and gingival level (GL) were assessed after crown placement at 6 and 12 months post‐surgery. Results: The overall 4‐month implant success rate was 95.8% (one implant failed). A total of 20 of 24 patients completed the study. At baseline, there were no significant differences between crestal and subcrestal groups in all clinical parameters except for the facial MBL (P = 0.035). At 4 months, the subcrestal group had significantly more tissue thickness gain (keratinized tissue) than the crestal group compared to baseline. Other clinical parameters (papilla index, PH, GL, PI, and GI) showed no significant differences between groups at any time. A facial plate thickness ≤1.5 mm and HDD ≥2 mm were strongly correlated with the facial marginal bone loss. A facial plate thickness ≤2 mm and HDD ≥3 were strongly correlated with horizontal dimensional changes. Conclusions: The use of immediate implants was a predictable surgical approach (96% survival rate), and the level of placement did not influence horizontal and vertical bone and soft tissue changes. This study suggests that a thick facial plate, small gaps, and premolar sites were more favorable for successful implant clinical outcomes in immediate implant placement.     

上前牙区单个种植牙牙龈生物学类型对龈乳头重建的影响

目的:观察上颌前牙区单个种植牙近远中龈乳头高度变化,并分析不同牙龈生物学类型对龈乳头重建的影响.方法:选择30例上前牙区单牙缺失患者,分别植入Straumann软组织水平种植体.所有患者在3个月后取模时,用直接测量方法测量种植体唇侧黏膜厚度,将其分为A组(黏膜厚度≥1.5 mm,16例)、B组(黏膜厚度＜1.5 mm,14例)2组.在修复体戴入时(基线期)和6个月后(随访期)观察近、远中龈乳头充盈度,并测量龈乳头高度及龈乳头-冠接触点的距离.采用SPSS19.0软件包分析6个月后近、远中龈乳头高度的变化,比较龈乳头高度在A、B2组间的差异.结果:所有种植体的留存率为100％. 60个龈乳头的平均高度在基线期和随访期分别为(1.64-±0.97)mm和(3.10±1.39)mm,平均增加(1.46±0.75)mm,具有显著差异(P＜0.05).在A组,近、远中龈乳头-冠接触点的平均距离分别为(O.15±0.24)mm和(0.23±0.33)mm,充盈度则为(97±5)％和(94±8)％;而在B组,近、远中龈乳头-冠接触点的平均距离分别为(1.94±0.40)mm和(2.10±0.34)mm,充盈度则为(53±9)％和(43±14)％.A、B两组间有显著差异(P＜0.05).结论:上颌前牙区单个种植牙修复后6个月,两侧的龈乳头高度可随着时间产生不同程度的增加,而龈乳头的增加则受不同的牙龈生物学类型的影响.其中,厚龈生物型比薄龈生物型在龈乳头重建方面有着更好的再生潜力.     

Interproximal tissue dimensions in relation to adjacent implants in the anterior maxilla: clinical observations and patient aesthetic evaluation

Objectives: This clinical study aimed to assess (i) interproximal tissue dimensions between adjacent implants in the anterior maxilla, (ii) factors that may influence interimplant papilla dimensions, and (iii) patient aesthetic satisfaction. Material and methods: Fifteen adults, who had two or more adjacent implants (total of 35) in the anterior maxilla, participated in the study. The study design involved data collection from treatment records, clinical and radiographic assessment, and a questionnaire evaluating aesthetic satisfaction. Results: The median vertical dimension of interimplant papillae, i.e., distance from tip of the papilla to the bone crest, was 4.2 mm. Missing papilla height (PH) at interimplant sites was on average 1.8 mm. Median proximal biologic width at interimplant sites was 7 mm. The most coronal bone‐to‐implant contact at implant–implant sites was located on average 4.6 mm apical to the bone crest at comparable neighbouring implant–tooth sites. The tip of the papilla between adjacent implants was placed on average 2 mm more apically compared with implant–tooth sites. The contact point between adjacent implant restorations extended more apically by 1 mm on average compared with implant–tooth sites. Median missing PH was 1 mm when an immediate provisionalization protocol had been followed, whereas in the case of a removable temporary it was 2 mm. Split group analysis showed that for missing PH≤1 mm, the median horizontal distance between implants at shoulder level was 3 mm. Patient satisfaction with the appearance of interimplant papillae was on average 87.5%, despite a Papilla Index of 2 in most cases. Conclusions: The apico‐coronal proximal biologic width position and dimension appear to determine papilla tip location between adjacent implants. There was a significant association between the provisionalization protocol and missing PH, which was also influenced by the horizontal distance between implants. Patient aesthetic satisfaction was high, despite a less than optimal papilla fill.     

影响上颌中切牙单个种植修复体龈乳头高度的因素分析

目的分析影响上颌中切牙单个种植修复体龈乳头高度的因素，探讨促进种植修复美学效果的相关因素。方法选择16例上颌中切牙单个种植修复患者（30个龈乳头），通过分析临床资料、口内照片、X线片和研究模型，得到龈乳头高度及相关因素数据，采用多重线性回归方法进行分析。结果16例患者中切牙种植修复体龈乳头高度为（4．01±1．85）mm，影响龈乳头高度的相关因素按作用由大到小的排列顺序为：种植修复体外冠接触点高度、邻近天然牙邻面牙槽嵴顶高度、邻近天然牙邻面牙槽嵴顶到外冠接触点的垂直距离、种植修复体外冠邻面凸度、种植体基台与邻牙牙根距离、冠根长度比例、种植修复体邻面牙槽嵴顶高度、种植修复体外冠唇面凸度、探诊深度。结论中切牙种植修复体龈乳头高度受多种因素影响。     

Evaluation of the presence or absence of papilla between tooth and implant

OBJECTIVE: The purpose of this study was to evaluate the papilla level adjacent to single-tooth implants in the maxillary anterior region in individuals with cleft lip, alveolus, and palate to verify whether there is correlation among the vertical distance, horizontal distance, dental/prosthetic crown shape, and periodontal/peri-implant biotype with the presence of interproximal papilla. DESIGN: Cross-sectional. SETTING: Hospital for Rehabilitation of Craniofacial Anomalies, University of S?o Paulo (HRAC/USP). PATIENTS: 77 papillae in 40 patients. Interventions: The periodontal/peri-implant biotype was clinically evaluated and characterized as thin or thick. Intraoral photographs were used to evaluate the presence or absence of papilla. MAIN OUTCOME MEASURES: Classification in scores (0 to 3) and determination of length (CL) and width (CW) of crowns adjacent to papillae. The CW/CL ratio was calculated for each crown in order to characterize it as square-shaped or triangular-shaped. The vertical and horizontal distances were obtained by radiographic evaluation. Results: The correlations between vertical distance and papilla score and horizontal distance and papilla score were statistically significant (p = .02 and p = .01). There was no significant difference between crown shape and periodontal/peri-implant biotype in distinct correlations with the papilla score (p = .41 and p = .07). CONCLUSION: The results suggest that the vertical and horizontal distances may have independent or combined relationship with the existence of interproximal papilla; the periodontal/peri-implant biotype (phenotype) was not correlated with the presence or absence of papilla, as well as the shape of the dental/prosthetic crown.     

Dimension of keratinized mucosa and the interproximal papilla between adjacent implants

BACKGROUND: The interproximal papilla between two adjacent implants is gaining critical interest in the implant dentistry. The aims of this study were to evaluate the effect of 1) the width of keratinized mucosa, 2) the distance from the base of the contact point to the crestal bone, and 3) the horizontal distance between two implants on the radiographic dimension from the tip of the papilla to the crestal bone between two implants. METHODS: This study involved 72 interproximal papillae between two adjacent implants (interimplant papilla) in 52 patients who had implants placed adjacent to each other and had a prosthesis in place more than 1 year. The shortest distance between the radiopaque material on the tip of the interimplant papilla and most coronal portion of the interimplant crestal bone was measured (the radiographic length of the papilla [RL]). The width of keratinized mucosa from the tip of the papilla was measured (WK). The vertical distance between the base of the contact point and the interimplant crestal bone was measured (CC). The horizontal distance between the two adjacent implants was measured at the fixture-abutment interface level (HD). Multiple regression analysis was performed between WK-RL, CC-RL, and HD-RL. RESULTS: RL had a significant relation with WK between two adjacent implants (P = 0.001). However, RL was not related with other variables, such as CC and HD (CC, P = 0.641; HD, P = 0.901). CONCLUSION: The results of this study suggest that the width of keratinized mucosa between two adjacent implants might be related to the dimension of the interproximal papilla between two adjacent implants.     

Factors affecting soft tissue level around anterior maxillary single‐tooth implants

Background: Peri‐implant soft tissue recession is a major esthetic concern for the anterior implants. The aim of this study was to determine the factors that affected the facial marginal mucosal level and papilla level around single‐tooth implants in the anterior maxilla. Methods: Forty single‐tooth implants in the anterior maxilla were studied. Variables possibly associated with the soft tissue level were obtained from clinical measurements, study models, peri‐apical radiographs, and computerized tomograms. Fisher's exact test, analysis of variance, and binary logistic regression analysis were used to determine the influence of each factor on the facial marginal mucosal level and papilla level. Results: The majority of the implants (75%) replaced the upper central incisors. The facial mucosal margin of the implant was 0.5±0.9 mm more apical than that of the contralateral tooth. Half or more of papilla fill was observed in 89% of the samples. More apical level of the facial mucosal margin at the implant sites was significantly influenced by many factors including a thin peri‐implant biotype, a proclined implant fixture angle, more apical level of the facial bone crest, increased distance from the contact point to the bone crest, contact point to the platform, and contact point to implant bone. A thin biotype was the most significant factor in determining the facial marginal mucosal level. Increased distance from the contact point to the bone crest was the only factor significantly associated with less papilla fill. Conclusions: The papilla level around single‐tooth implants in the anterior maxilla was mainly influenced by the interproximal bone crest level of the adjacent tooth. Facial marginal mucosal level, on the other hand, was affected by multiple factors including the peri‐implant biotype, the facial bone crest level, the implant fixture angle, the interproximal bone crest level, the depth of implant platform, and the level of first bone to implant contact. To cite this article:
Nisapakultorn K, Suphanantachat S, Silkosessak O, Rattanamongkolgul S. Factors affecting soft tissue level around anterior maxillary single‐tooth implants.
Clin. Oral Impl. Res. 21 , 2010; 662–670.
doi: 10.1111/j.1600‐0501.2009.01887.x     

Effect of the vertical and horizontal distances between adjacent implants and between a tooth and an implant on the incidence of interproximal papilla

BACKGROUND: The interproximal dental papilla is considered an essential component of the anterior and posterior regions of the maxilla and mandible. The absence of this structure has esthetic and phonetical consequences and lateral food impaction problems occur with the implant-supported prosthesis. The aims of the present study were to: 1) evaluate the effect of the vertical and horizontal distances between adjacent implants (group 1) and between a tooth and an implant (group 2) on the presence of the interproximal dental papilla; and 2) determine whether the interaction between the vertical and horizontal distances might be associated with the incidence of the papilla. METHODS: In 48 patients, 96 interproximal sites in group 1 and 80 in group 2 were examined. The distance from the base of the contact point to the bone crest (D1), the distance between tooth and implant or between two implants (D2), and the distance from the base of the contact point to the tip of the papilla (D3) were measured. RESULTS: In both groups, when D2 was 3, 3.5, or 4 mm, the papilla was present most of the time (P < 0.05), and when D2 was 2 or 2.5 mm, the papilla was absent 100% of the time (P < 0.05). Further, in group 2, when D1 was between 3 and 5 mm, the papilla was present most of the time (P < 0.05). However, in Group 1, only when D1 was 3.0 mm was the papilla present most of the time (P < 0.05). For both groups, analysis of the interaction between D1 and D2 showed that when D2 was < or = 2.5 mm, the papilla was absent; otherwise, when D2 was > or = 3 mm, there was an interaction between D1 and D2. CONCLUSIONS: We conclude that the ideal distance from the base of the contact point to the bone crest between adjacent implants is 3 mm and, between a tooth and an implant, 3 mm to 5 mm. The ideal lateral spacing between implants and between tooth and implant is 3 mm to 4 mm. Further, there is an interaction between horizontal and vertical distances when the lateral spacing is greater than 3 mm.     

Surgical and prosthetic management of interproximal region with single-implant restorations: 1-year prospective study

BACKGROUND: Gingival esthetics around dental implants have become a main focus for clinicians. This study analyzed the surgical, prosthetic, and anatomic factors involved in the management of peri-implant tissues. METHODS: Forty-eight subjects with one tooth scheduled for tooth extraction and immediate implant placement were included in the study. After healing, the implants were restored with single-crown fixed prostheses. The following parameters were assessed after 12 months: presence/absence of the interproximal papilla, interimplant-tooth distance (ITD), distance from the base of the contact point to the interdental bone (CPB), and soft tissue biotype. ITD and CPB values were derived from computer analysis of periapical radiographs. A statistical analysis determined the effect of ITD and CPB on the presence of the interproximal papilla. RESULTS: Papilla was significantly present (P <0.05) for ITD of 2.5 to 4 mm in anterior and posterior areas and for CPB < or =7 mm in posterior areas. Thick biotype was significantly associated (P <0.05) with the presence of the papilla. CONCLUSIONS: The combination of surgical and prosthetic plans represents the key factor to optimize predictability in single-implant esthetics. The recommended interproximal distance between the implant and the adjacent tooth is 2.5 to 4 mm. The distance from the contact point to the interdental bone is recommended to be <7 mm. Papilla presence is also correlated with a thick gingival biotype.     

伴牙槽嵴吸收的牙周炎患者上前牙龈乳头缺陷程度影响因素初探

目的:探讨有牙槽嵴吸收时上前牙不同程度龈乳头缺陷的相关影响因素。方法:选择2019年6至12月就诊于北京大学口腔医学院·口腔医院牙周科,且经治疗后牙周炎控制稳定并定期进行牙周维护的14例牙周炎患者的64个上前牙龈乳头,通过标准化临床图像及锥形束CT影像资料综合分析,评价邻接触点至骨嵴顶的距离（distance from...     

Effect of interimplant distance (2 and 3 mm) on the height of interimplant bone crest: a histomorphometric evaluation

Background: Implants restored according to a platform‐switching concept (implant abutment interface with a reduced diameter relative to the implant platform diameter) present less crestal bone loss than implants restored with a standard protocol. When implants are placed adjacent to one another, this bone loss may combine through overlapping, thereby causing loss of the interproximal height of bone and papilla. The present study compares the effects of two interimplant distances (2 and 3 mm) on bone maintenance when bone‐level implants with platform‐switching are used. Methods: This study evaluates marginal bone level preservation and soft tissue quality around a bone‐level implant after 2 months of healing in minipig mandibles. The primary objective is to evaluate histologically and histomorphometrically the affect that an implant design with a horizontally displaced implant–abutment junction has on the height of the crest of bone, between adjacent implants separated by two different distances. Results: Results show that the interproximal bone loss measured from the edge of the implant platform to the bone crest was not different for interimplant distances of 2 or 3 mm. The horizontal position of the bone relative to the microgap on platform level (horizontal component of crestal bone loss) was 0.31 ± 0.3 mm for the 2‐mm interimplant distance and 0.57 ± 0.51 mm above the platform 8 weeks after implantation for the 3‐mm interimplant distance. Conclusions: This study shows that interimplant bone levels can be maintained at similar levels for 2‐ and 3‐mm distances. The horizontally displaced implant–abutment junction provided for a more coronal position of the first point of bone–implant contact. The study reveals a smaller horizontal component at the crest of bone than has been reported for non‐horizontally displaced implant–abutment junctions.     

Clinical and radiographic evaluation of the papilla level adjacent to single-tooth dental implants. A retrospective study in the maxillary anterior region.

BACKGROUND: The regeneration of gingival papillae after single-implant treatment is an area of current investigation. This study was designed to determine: 1) whether the distance from the base of the contact point to the crest of the bone would correlate with the presence or absence of interproximal papillae adjacent to single-tooth implants, and 2) whether the surgical technique at uncovering influences the outcome. METHODS: A clinical and radiographic retrospective evaluation of the papilla level around single dental implants and their adjacent teeth was performed in the anterior maxilla in 26 patients restored with 27 implants. Six months after insertion, 17 implants were uncovered with a standard technique, while 10 implants were uncovered with a technique designed to generate papilla-like formation around dental implants. Fifty-two papillae were available for clinical and radiographic evaluation. The presence or absence of papillae was determined, and the effects of the following variables were analyzed: the influence of the 2 surgical techniques; the vertical relation between the papilla height and the crest of bone between the implant and adjacent teeth; the vertical relation between the papilla level and the contact point between the crowns of the teeth and the implant; and the distance from the contact point to the crest of bone. RESULTS: When the measurement from the contact point to the crest of bone was 5 mm or less, the papilla was present almost 100% of the time. When the distance was > or = 6 mm, the papilla was present 50% of the time or less. The mean distance between the crest of bone and the most coronal papilla level (interproximal soft tissue height) was 3.85 mm (SD = 1.04). When comparing the conventional and modified surgical technique, the relation shifted from 3.77 mm (SD = 1.01) to 4.01 mm (SD = 1.10), respectively. CONCLUSIONS: These results clearly show the influence of the bone crest on the presence or absence of papillae between implants and adjacent teeth. The data also show a positive influence for the modified surgical technique, aimed at reconstructing papillae at the implant uncovering.     

Dimension of interproximal soft tissue between adjacent implants in two distinctive implant systems

BACKGROUND: The purpose of this study was to compare the dimension of interproximal soft tissue between adjacent implants in distinctive implant systems. METHODS: This study involved 85 interproximal papillae between two adjacent implants in 50 patients who had implants placed adjacent to each other and who had prosthesis in place for longer than 1 year. The shortest distance between the radiopaque material on the tip of interimplant papilla and the most coronal portion of the interimplant crestal bone was measured (radiographic length of papilla [RL]). The horizontal distance (HD) between the two adjacent implants was measured at the fixture-abutment interface level. Considering the possible effect of interimplant crestal bone resorption on closely implanted sites, HDs were divided into two categories: HD <3 and >or=3 mm. The Mann-Whitney test was performed to find the difference in the dimension of interimplant papilla. RESULTS: In cases of HD <3 mm, RL did not differ statistically in both systems. Also, in cases of HD >3 mm, RL did not show a statistically significant difference in both systems. CONCLUSION: Both systems had similar dimensions of interproximal soft tissue between adjacent implants, irrespective of the horizontal distance of the fixture.     

Outcome analysis of immediately placed, immediately restored implants in the esthetic area: the clinical relevance of different interimplant distances

BACKGROUND: The purpose of this study was to compare and evaluate bone and soft tissue levels between immediately placed, immediately restored implants positioned in the esthetic anterior region with different interimplant distances (IID). METHODS: Forty-nine patients requiring multiple implant restorations in the anterior regions received 152 implants, which were restored immediately. Periapical radiographs and digital images of 99 interimplant sites were taken at the regular follow-up examinations at 0, 6, 12, and 24 months after surgery. They were digitally recorded and analyzed. The presence of the interproximal papilla was assessed and compared to the distances between the bone crest and the contact point between the natural teeth and the restoration crowns. RESULTS: Implants with an IID <2 mm seemed to lose less bone laterally. When the IID was <2 mm, vertical crestal bone loss was significantly greater than in the group with IID >4 mm. The percentage of the interproximal papilla presence decreased when the distance between the bone crest and the contact point between the two restoration crowns was >6 mm and when two implants were placed at a distance > or =4 mm. CONCLUSIONS: To guarantee a better esthetic result in immediately placed, immediately restored implants, the contact point between the two prosthetic crowns should be placed at 3 to 4 mm, and never >6 mm, from the bone peak. Two adjacent implants should be placed at a distance >2 and <4 mm.     

前牙区不翻瓣即刻牙种植术后软硬组织变化的研究

目的:评测前牙区不翻瓣即刻牙种植的近期临床效果及软硬组织变化。方法:2008-07—2012-11于同济大学附属口腔医院种植科就诊的患者中,选择上颌前牙无法保留,适合采取即刻不翻瓣种植的患者纳入实验。于术中,术后3个月、6个月分别测量缺失牙近、远中骨高度及牙龈乳头的高度。结果:共18例患者22颗患牙纳入本研究。X线结果表明种植体均形成良好骨结合。种植后3个月,牙槽骨唇颊侧骨板近、远中吸收分别为(0.47±0.03)mm和(0.56±0.06)mm;6个月时骨吸收分别为(1.60±0.05)mm和(1.73±0.04)mm。种植3个月时,近、远中牙龈附着退缩为(0.41±0.05)mm和(0.53±0.03)mm,6个月牙龈时附着退缩分别为(0.51±0.03)mm和(0.62±0.04)mm。结论:前牙区不翻瓣即刻牙种植能良好地保存种植体周围骨组织及软组织高度,在选择合适适应证的条件下,能在减少手术创伤的基础上获得良好的修复效果。     

Dimensional Influence of Interproximal Areas on Existence of Interdental Papillae

Background: Restoring papillae in the gingival embrasures of the esthetic zone is a key consideration in periodontal, restorative, and orthodontic treatment. This study analyzes the existence of interdental papillae with regard to the vertical dimensions between the contact point and the alveolar crest and horizontal dimensions between adjacent roots. Methods: A total of 259 papillae, in 60 patients, were examined. All patients were indicated for full‐thickness periodontal flap surgery. A mucoperiosteal flap was raised and, after thorough debridement, horizontal and vertical dimensions between adjacent roots were recorded. The incidence of papillae was analyzed using χ² for linear trend analysis. Results: Interdental papillae were present in 85.7% of the cases when the vertical dimensions were 4 mm (P <0.05). Also, papillae were present in 78.5% of cases when the horizontal dimensions were between 0.5 and 1 mm (P <0.05). Conclusion: The vertical and horizontal dimensions of interproximal areas had a substantial, independent, and combined effect on the existence of interproximal papillae.     

影响龈乳头高度的因素

口腔软组织美学已越来越受重视.龈乳头形态是影响口腔软组织美观的重要因素之一.龈乳头高度的丧失导致黑三角的形成.在前牙区,黑三角不仅带来功能性问题,也影响发音和美观.国内外学者对影响龈乳头高度的因素进行了一系列研究,包括患者年龄,牙龈生物型,以及牙冠外形、接触点-牙槽嵴顶距离、牙间距、根间分离角、龈外展隙形态等形态学因素...     

影响龈乳头高度的因素

口腔软组织美学已越来越受重视。龈乳头形态是影响口腔软组织美观的重要因素之一。龈乳头高度的丧失导致黑三角的形成。在前牙区,黑三角不仅带来功能性问题,也影响发音和美观。国内外学者对影响龈乳头高度的因素进行了一系列研究,包括患者年龄,牙龈生物型,以及牙冠外形、接触点-牙槽嵴顶距离、牙间距、根间分离角、龈外展隙形态等形态学因素。临床医生必须了解评估龈乳头高度的参数才能准确地判断治疗效果及实现龈乳头的再生。     

Long-term follow-up of turned single implants placed in periodontally healthy patients after 16-22 years: radiographic and peri-implant outcome

Objectives: Retrospectively evaluate the survival, radiographic and peri‐implant outcome of single turned Brånemark^? implants after at least 16 years. Materials and methods: From 134 patients (C‐group), 101 could be contacted concerning implant survival and 50 (59 remaining implants) were clinically examined (I‐group). Marginal bone level was radiographically measured from the implant–abutment junction at baseline (=within 6 months after abutment connection) and 1–4, 5–8 and 16–22 years post‐operatively. Probing depth, gingival and plaque index were measured. Marginal bone‐level changes were analyzed using Friedman's and Wilcoxon's signed ranks tests. Spearman's correlations between radiographic and clinical parameters were calculated. Results: In the C‐group, 13 out of 166 implants in 11 out of 134 patients failed (CSR=91.5%). In the I‐group (28 males–22 females; mean age 23.9 years at baseline; range 14–57), the mean follow‐up was 18.4 years (range 16–22). The mean bone level was 1.7±0.88 mm (range ?0.8 to 5) after 16–22 years. Changes in the mean marginal bone level were statistically significant between baseline and the second measuring interval (1–4 years). Thereafter, no significant differences could be demonstrated. The mean interproximal probing depth, gingival and plaque indices were 3.9±1.27 mm, 1.2±0.81 and 0.2±0.48, respectively. Probing depth was moderately correlated with gingival inflammation (r=0.6; P<0.001) but not with bone level (P>0.05). 81.4% of the implants had a bone level ≤2nd thread and 91.5% had a probing depth ≤5 mm. 76.3% had both bone level ≤2nd thread and probing depth ≤5 mm. Conclusions and clinical implications: The single turned Brånemark^? implant is a predictable solution with high clinical survival and success rates. In general, a steady‐state bone level can be expected over decades, with minimal signs of peri‐implant disease. A minority (5%), however, presents with progressive bone loss. To cite this article :
Dierens M, Vandeweghe S, Kisch J, Nilner K, De Bruyn H. Long‐term follow‐up of turned single implants placed in periodontally healthy patients after 16–22 years: radiographic and peri‐implant outcome.
Clin. Oral Impl. Res. 23 , 2012; 197–204. doi: 10.1111/j.1600‐0501.2011.02212.x