The aim of this study was to assess bone and soft tissue changes after tooth extraction and immediate implant insertion in the anterior maxilla. A novel synthetic bone graft (VivOss, Straumann) was used to fill the gap between the implant surface and the alveolar bone. Implants with a reduced diameter compared to the size of the socket were used. A fixed or removable provisional restoration was provided immediately after implant placement. Cone beam computed tomography (CBCT) scans were taken to evaluate bone changes, showing minor variations after 12 months of follow-up. To evaluate soft tissue changes, clinical vertical measurements were performed. Based on the results obtained from 15 implants placed in 14 patients, it can be concluded that the use of an immediate implant in combination with a synthetic bone graft and immediate provisionalization seems to be a predictable treatment option with satisfactory esthetic results after 1 year.

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Background Narrow diameter implants (NDIs) are used in cases of limited mesio‐distal space, or if the alveolar ridge does not allow placement of a standard diameter implant. Purpose The aim of this prospective case series study is to present the 5‐year clinical‐, radiological‐, and patient‐reported outcome measures (PROMs) of patients with partial edentulism in the anterior area of the jaws requiring the placement of two narrow diameter implants to support a 3‐ or 4‐unit fixed partial denture (FPD). Materials and Methods Thirty partially edentulous patients missing 3 or 4 adjacent teeth in the anterior area of the jaws were included in the study. Two titanium–zirconium tissue‐level NDIs were placed in each patient in healed anterior sites (60 implants). A conventional loading protocol was performed to provide a FPD. Implant survival, success, marginal bone‐level changes (MBL), clinical parameters, buccal bone stability with CBCT, adverse events and PROMs were recorded. Results The survival and success rates for the implants were 100%. The mean MBL (±SD) after prosthesis delivery, and 5‐year follow‐up (mean 58.8 months; range: 36–60) was 0.12 ± 0.22 and 0.52 ± 0.46 mm, respectively. Decementation and screw loosening were the most frequent prosthetic complications, yielding a prosthetic survival and success rates of 100% and 80%, respectively. Patient satisfaction was high with a mean (±SD) score of 89.6 ± 15.1. Conclusions The use of tissue‐level titanium–zirconium NDIs supporting splinted multi‐unit FPDs in the anterior area seems to be a safe and predictable treatment option after a 5‐year follow‐up period.

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