The consensus statements, the clinical recommendations, and the implications for research, all of them after approval by the plenum of the consensus conference, are described in this article. The three articles by Vercruyssen et al., Patzelt & Kohal, and Benic et al. are presented separately as part of the supplement of this consensus conference.
Aim: To test whether the emergence profile (CONVEX or CONCAVE) of implantsupported crowns influences the mucosal margin stability up to 12 months after insertion of the final restoration.Materials and Methods: Forty-seven patients with a single implant in the anterior region were randomly allocated to one of three groups: (1) CONVEX (n = 15), implant provisional and an implant-supported crown both with a convex profile;(2) CONCAVE (n = 16), implant provisional and an implant-supported crown both with a concave profile; (3) CONTROL (n = 16), no provisional (healing abutment only) and an implant-supported crown. All patients were recalled at baseline, 6, and 12 months. The stability of mucosal margin along with clinical, aesthetic, and profilometric outcomes as well as time and costs were evaluated. To predict the presence of recession, multivariable logistic regressions were performed and linear models using generalized estimation equations were conducted for the different outcomes.Results: Forty-four patients were available at 12 months post-loading. The frequency of mucosal recession amounted to 64.3% in group CONVEX, 14.3% in group CONCAVE, and 31.4% in group CONTROL. Regression models revealed that a CONVEX profile was significantly associated with the presence of recessions (odds ratio: 12.6, 95% confidence interval: 1.82-88.48, p = .01) compared with the CONCAVE profile. Pink aesthetic scores amounted to 5.9 in group CONVEX, 6.2 in group CONCAVE, and 5.4 in group CONTROL, with no significant differences between the groups (p = .735). Groups CONVEX and CONCAVE increased the appointments and costs compared with the CONTROL group.Conclusions: The use of implant-supported provisionals with a CONCAVE emergence profile results in a greater stability of the mucosal margin compared with a CONVEX profile up to 12 months of loading. This is accompanied, however, by increased time and costs compared with the absence of a provisional and may not Marina Siegenthaler and Franz J. Strauss contributed equally to the manuscript and should be considered as joint first authors.
Both implant systems reveal high survival rates on the implant and prosthetic level. Apart from marginal bone-level changes, biological and technical outcomes did not reveal significant differences between the two implant systems.
Objectives
To assess clinical, technical, and esthetic outcomes of veneered zirconia reconstructions cemented on non‐original titanium bases over 1 year.
Materials and methods
Twenty‐four healthy patients presented with one missing tooth in the anterior maxilla or mandible and received a two‐piece dental implant. The implants were restored with a screw‐retained crown using a directly veneered zirconia reconstruction, which was extraorally cemented on a titanium base. After crown insertion, patients were scheduled for a baseline examination and re‐examined at 6 months and at 1 year of loading. Measurements included biological, technical, and esthetic parameters. Data were analyzed with nonparametric tests.
Results
Mean marginal bone levels measured 0.54 ± 0.39 mm (median: 0.47, range: 0.07–1.75 mm) at baseline and 0.54 ± 0.45 mm (median: 0.44, range: 0.06–1.52 mm) at 1 year. Mean probing depth (PD) (3.0 ± 0.6 mm at baseline to 3.5 ± 0.7 mm at 1 year [p = 0.002]), bleeding on probing (BOP) (27.1% ± 20.7% at baseline to 43.9% ± 28.0% at 1 year [p = 0.041]), plaque index (PI) (11.1% ± 21.2% at baseline to 18.2% ± 21.8% at 1 year [p = 0.381]) increased, whereas the width of the keratinized mucosa decreased from baseline to 1 year (3.1 ± 1.3 mm at baseline to 3.0 ± 1.2 mm at 1 year [p = 0.398]). Four implants (16.7%) were diagnosed with peri‐implantitis (BOP positive, bone loss >1 mm) during the 1‐year observation period. One implant was lost at 3 ½ months, resulting in a 95.8% survival rate. Four technical complications occurred and led to 83.3% complication‐free reconstructions.
Conclusion
A significant increase in PD and BOP values was observed using directly veneered zirconia reconstructions cemented on non‐original titanium bases.
Both types of reconstructions were similar in terms of esthetics. Incases with a mucosal thickness of <2 mm, the soft tissue discoloration compared to the natural gingiva was more pronounced for the fluorescent hybrid zirconia reconstructions.
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