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Clin Oral Implants Res. 2020 Feb;31(2):173-180. doi: 10.1111/clr.13553. Epub 2019 Nov 18.

Performance of bone-level implants with conical connections in the anterior maxilla: A 5-year prospective cohort study.

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Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Department of Implant Dentistry, Dental School, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.



To assess clinical, radiographic and aesthetic outcomes, and satisfaction of patients treated with single implant restorations in the maxillary aesthetic region 5 years after final restoration.


Sixty patients (29 male/31 female, mean age 37 years) with a missing anterior tooth in the maxilla (39 central incisors/10 lateral incisors/5 cuspids/6 first premolars) received a bone-level implant with conical connection. In 29 patients, a bone augmentation procedure was necessary before implant placement (autogenous bone grafts mixed with spongiosa granules). All implants (12 with 3.3 mm diameter/ 48 with 4.1 mm diameter) were loaded after 3 months of submerged healing. The restoration consisted of an individually designed full-zirconia abutment veneered with porcelain. Follow-up with clinical and radiographic assessment was conducted until 60 months after the final restoration. Aesthetic outcome of the restoration was determined with the Pink Esthetic Score-White Esthetic Score (PES-WES). Patient satisfaction was assessed with a VAS scale and satisfaction questionnaire.


Fifty patients completed the 5-year follow-up. Implant survival was 100%, restoration survival 98%. Mean bone-level change was -0.13 ± 0.66 mm with a median (IQR) pocket probing depth of 2.75 [2.25; 3.25]. The mean PES and WES scores were 6.6 ± 1.7 and 7.8 ± 1.5, respectively. Patient satisfaction was high (92.1 ± 7.8 on 100 mm VAS scale). There were no differences between patients with or without a bone augmentation procedure.


Bone-level implants with a conical connection are a reliable treatment option in single-tooth replacements in the maxillary aesthetic zone.


aesthetic region; bone augmentation; dental implants; maxilla; single-tooth

[Indexed for MEDLINE]

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