Immediately restored single implants in the aesthetic zone of the maxilla using a novel design: 5-year results from a prospective single-arm clinical trial

Background Single implant crowns have become the preferred rehabilitation treatment option for replacing a missing tooth. Purpose This study evaluates 5-year clinical success of using tilted implants placed immediately after extraction followed by rehabilitation with all-ceramic crowns. Materials and Methods Twenty-seven participants requiring 28 single implant crowns in the aesthetic zone of maxilla were recruited to participate in a single-arm clinical trial. All participants were rehabilitated according to immediate implant placement using CP grade 4 titanium implants with roughened surfaces and a 12 degrees-angled platform. Provisional implant crowns were connected within 4 hours of implant placement and loaded according to progressive loading protocol. At 8 weeks (baseline), definitive screw-retained crowns fabricated using densely sintered zirconia abutments with the veneering porcelain were delivered. Participants were followed up to 5 years and 16 participants with 17 single implant crowns attended Year 5 recall. Data collection included changes in marginal bone levels (MBLs), mid-buccal mucosal levels (MBMLs), implant stability quotient (ISQ) values, and any prosthodontic maintenance issues. Results The mean changes in MBLs at each recall was bone fill of 0.5 +/- 1.18 mm (surgery-baseline), increase of 0.1 +/- 0.57 mm (baseline-Year 1), and marginal bone loss of 0.1 +/- 0.25 mm (Years 1-5). A minimal change occurred with the MBMLs during the observation period. The mean ISQ value at each time point increased from 65.1 (implant placement), to 67.4 (baseline) and 69.9 (Years 1 and 5). Prosthodontic maintenance issues occurred only during the first year which included fracture of veneering ceramic and zirconia abutment as well as aesthetic concerns. Conclusions Within the limitations of this study, the data collected would suggest that replacing a single missing tooth using titanium oral implants with 12 degrees platform tilt and zirconia abutments can be a successful rehabilitation option in the esthetically demanding zone of anterior maxilla.