title: A multicenter 12-month evaluation of single-tooth implants restored 3 weeks after 1-stage surgery.
abstract: The time-intensive, multi-step process of dental implant therapy limits patient acceptance. This 3-year prospective multicenter study sought to determine the safety of an expedited therapy that consisted of loading unsplinted maxillary anterior single-tooth implants 3 weeks after 1-stage surgical placement, and determination of the peri-implant cortical bone and mucosal responses to the expedited procedure. Fifty-two patients missing 1 or 2 maxilliary anterior teeth were enrolled in a study approved by the Institutional Committee on Human Subjects Research and based on strict inclusion and exclusion criteria. Astra Tech ST implants placed in a 1-stage procedure were restored 3 weeks later with ST abutments and a provisional crown (baseline); 7 to 9 weeks later, a porcelain-fused-to-metal or all-ceramic crown was cemented. Radiographic and clinical examinations were made at baseline and at 6 and 12 months. Implant survival was recorded. Cortical bone responses and peri-implant mucosal responses were evaluated. Fifty-eight implants were placed. During the 3-week period after implant placement, 4 patients were dismissed because of smoking cigarettes (a protocol deviation), and 1 patient was excluded because of deviation in loading time. Of the remaining 53 implants, 2 failed before definitive crown cementation. The resultant 96.2% survival rate was independent of implant length, tooth position, and bone quality/quantity. The mean change in marginal bone level was 0.4 mm at 12 months. The number of surfaces with plaque decreased from 3.4% at baseline to 0.5% at 12 months. The surfaces with inflammation also decreased. A mean gain in papilla length of 0.61 mm occurred, and a gain in buccal gingiva (x = 0.34 mm) was observed. A high success rate with positive tissue responses was achieved for maxillary anterior unsplinted single-tooth implants placed in a 1-stage surgery and restored at 3 weeks. This 2-component system is suited to a single-stage, rapid loading protocol for esthetic single-tooth replacement.
authors.affiliation: Department of Prosthodontics, University of North Carolina, 404 Brauer Hall CB#7450, Chapel Hill, North Carolina 27599, USA. Lyndon_Cooper@Dentistry.unc.edu
authors.forename: L
authors.initials: L
authors.lastname: Cooper
authors.forename: D A
authors.initials: DA
authors.lastname: Felton
authors.forename: C F
authors.initials: CF
authors.lastname: Kugelberg
authors.forename: S
authors.initials: S
authors.lastname: Ellner
authors.forename: N
authors.initials: N
authors.lastname: Chaffee
authors.forename: A L
authors.initials: AL
authors.lastname: Molina
authors.forename: J D
authors.initials: JD
authors.lastname: Moriarty
authors.forename: D
authors.initials: D
authors.lastname: Paquette
authors.forename: U
authors.initials: U
authors.lastname: Palmqvist
mesh_terms: D000222:Adaptation, Physiological; D000328:Adult; D000539:Alveolar Process / Q000502:physiology; D003442:Crowns; D000044:Dental Abutments; D003758:Dental Implantation, Endosseous / Q000379:methods*; D019250:Dental Implants, Single-Tooth; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D005260:Female; D005881:Gingiva / Q000502:physiology; D006801:Humans; D007180:Incisor; D008297:Male; D008437:Maxilla; D016348:Osseointegration; D011446:Prospective Studies; D012907:Smoking