A prospective clinical study with 60 patients on the performance of a bone level tapered implant in the aesthetic zone

Background: Implant placement in the aesthetic zone can be challenging due to morphological deficiencies. A tapered implant core could be beneficial in optimal implant placement, and preferred over cylindrical implants. Optimal placement is favourable for achieving good aesthetics and helps to maintain healthy peri-implant tissues for a good long-term prognosis. A new implant design was launched that claimed to meet these requirements. Studies are needed to confirm the performance of the new tapered implant. Aim/Hypothesis: To report the one year performance outcome of solitary bone level implant with a tapered core and conical abutment connection in the aesthetic region of the maxilla. Materials and Methods: Sixty patients (31 male, 29 female) with a failing or missing single tooth in the anterior maxilla were included and treated according to their baseline dental status. Patients with a failing tooth, received socket preservation with a mucosa graft after extraction and 3 months later an implant with immediate provisionalization. Patients with a missing tooth (healed site) received an implant with simultaneous bone augmentation and after 3 months (late) provisionalization. Definitive crowns were placed 3 months after wearing the provisional. Follow-up examinations were done 1 month and 12 months after definitive crown placement. Clinical variables (pocket probing depth, bleeding score, and gingiva score, bone level change, aesthetic scores (PES/WES) and patient centred outcomes (questionnaire with VAS scale) were collected and analysed. Results: Thirty patients followed the procedure of the failed tooth (extraction and ridge preservation) and thirty patients the procedure of the missing tooth (healed site). Total survival rate is 98.3% (one implant lost in the failed tooth procedure; implant failed to integrate). Bone loss after one year is 0.12 ± 0.19 mm. Mid-buccal mucosa zenith retracted slightly with 0.07 ± 0.42 mm. Median PES and WES score resulted in 6 [4;7] and 8 [7;9] respectively. Patients reported their satisfaction on the function and aesthetics of the implant restoration with a mean of 81.98 ± 11.83 and 88.37 ± 8.69 respectively on a 0-100 VAS scale. No significant difference between the two groups was recorded for either clinical, radiographic, photographic or patient dependent parameters. Conclusions and Clinical Implications: Bone level tapered implants with a conical connection are a reliable treatment option for single tooth replacements in the maxillary aesthetic zone. No significant clinical or radiographic differences were found between patients with a preserved alveolar ridge or patients with an unassisted healed ridge. Future research could test the implants potential in higher risk sites. Keywords: Aesthetic region, bone augmentation, dental implant, maxilla, single-tooth