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

Objectives 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. Material and methods 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. Results 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. Conclusion Bone-level implants with a conical connection are a reliable treatment option in single-tooth replacements in the maxillary aesthetic zone.