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J Periodontal Implant Sci. 2017 Oct;47(5):312-327. English. Clinical Trial.
Gao E , Hei WH , Park JC , Pang K , Kim SK , Kim B , Kim SM , Lee JH .
Department of Stomatology, China-Japan Friendship Hospital, Beijing, China.
Key Laboratory for Oral Biomedical Engineering of Ministry of Education, Wuhan University School and Hospital of Stomatology, Wuhan, China.
Department of Oral and Maxillofacial Surgery, Seoul National University School of Dentistry, Seoul, Korea.
Department of Oral and Maxillofacial Surgery, Seoul National University Gwanak Dental Hospital, Seoul, Korea.
Department of Oral and Maxillofacial Surgery, Clinical Trial Center, Seoul National University Dental Hospital, Seoul, Korea.

PURPOSE: This study assessed marginal bone remodeling and soft tissue esthetics after the loading of single bone-level implants in the anterior maxilla. METHODS: An open, single-arm observational clinical trial with 3 years of follow-up was performed, including 22 implants. The patients presented with a single tooth gap in the anterior maxilla (tooth positions 14–24), with natural or restored adjacent teeth. An implant was placed at least 8 weeks post-extraction and healed submerged for 6 weeks. After the second-stage operation, a fixed provisional prosthesis was provided. The final restoration was placed 6 months after the provisional restoration. The time of the provisional crown connection was considered to be the baseline in this study. Esthetic parameters and the marginal bone level were assessed at 6, 12, 24, and 36 months. RESULTS: All implants were well integrated in the bone. A statistically significant increase was found in the mean implant stability quotient between the time of the provisional prosthesis and the time of the final prosthesis. Most implants (95.5%) revealed marginal bone resorption (<0.5 mm), and just 1 implant (4.5%) showed a change of 2.12 mm from baseline to 36 months (mean 0.07±0.48 mm), while the crestal bone level decreased significantly, from 2.34±0.93 mm at baseline to 1.70±1.10 mm at 36 months. The facial gingival margin and papilla were stable and the esthetic scores indicated high patient and dentist satisfaction. CONCLUSIONS: Platform-switching bone-level implants placed in maxillary single-tooth gaps resulted in successful osseointegration with minimal marginal bone resorption. The peri-implant soft tissue was also esthetically satisfying and stable.

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