Immediate implant insertion and nonfunctional immediate provisionalization in the esthetic zone: 5-year data of NobelPerfect Conical implants

The aim of this case series was to evaluate implant survival, marginal bone stability, and soft tissue esthetics of immediately inserted and provisionalized NobelPerfect Conical implants in the esthetic zone. Material and Methods: In five patients, 11 NobelPerfect Conical implants were inserted into extraction sockets and immediately provisionalized. Simultaneously, facial bone defects were augmented using flapless surgery with autogenous bone chips. The outcome variables included the survival rate, marginal bone levels, and pink esthetic score (PES). Results: No implant failed in the mean follow-up period of 60 months. Mean marginal bone levels apical to the implant shoulder changed from -0.42 +/- 1.14 mm preoperatively to 1.56 +/- 1.01 mm at 5-year follow-up. Mean PES ratings improved from 11.3 preoperatively to 12.3 at 5-year follow-up. Conclusions: Survival rates and the esthetic results suggest proof of principle for the long-term clinical success and the preservation of the peri-implant soft tissue esthetics. In spite of a conical implant-abutment connection and a platform switch, the scalloped implant shoulder seems unable to maintain the marginal bone level at the level of the implant shoulder.