title: Scalloped dental implants: a retrospective analysis of radiographic and clinical outcomes of 17 NobelPerfect implants in 6 patients.
abstract: BACKGROUND
  The scalloped dental implant (NobelPerfect, Nobel Biocare, Yorba Linda, CA, USA) is designed to biologically guide and facilitate interproximal bone remodeling during healing and to maintain bone height and papillae during functional loading. The design features of the scalloped implant include hard and soft tissue apposition areas, which are parallel to each other and mirror the cementoenamel junction. The hard tissue surface area is intended for osseointegration. The soft tissue surface area is meant to support the connective tissue zone and to provide a space for the subgingival margin of the restoration. Current literature on the clinical performance of the scalloped dental implant is limited.
  
  
  OBJECTIVE
  The aim of this study was to evaluate whether the scalloped dental implant maintains interproximal bone and the overlying soft tissue.
  
  
  METHODS
  Radiographs for six patients (mean age 40.5 years) treated with 17 implants (NobelPerfect) were reviewed for an 18-month follow-up evaluation of bone response. Orthodontic movement and/or autogenous bone augmentation had been provided to obtain the best possible soft and hard tissue dimensions prior to implant placement. A surgical guide was used for an optimal implant placement. No surgical flap was reflected, and implants were placed a minimum of 2 mm and a maximum of 3 mm apical (midbuccally) to the most apical portion of the surgical guide. Final optimal rotational alignment was achieved in all cases by not exceeding 45 Ncm. Implants were immediately restored with provisional crowns. Photographic documentation provided the basis for analysis of papillary response. Radiographic change in the interproximal bone level was obtained by computer analysis (ImageJ for Windows, National Institutes of Health, Bethesda, MD) by measuring the distance from the interproximal shoulder of the scalloped implant to the crest of the bone.
  
  
  RESULTS
  When the scalloped implants were placed adjacent to existing natural dentition, the average bone level at placement and at 6, 12, and 18 months was -1.7, -3.5, -3.8, and -3.9 mm, respectively, compared with -1.0, -3.6, -4.3, and -4.4 mm respectively, when placed adjacent to other scalloped implants. Papillae formation exhibited no differences from the configuration that typically results after placement of conventional dental implants. Moreover, bone loss around the scalloped implants was notably greater than that expected after traditional implant placement.
  
  
  CONCLUSIONS
  This chart review of 17 scalloped implants, followed for 18 months, determined that the scalloped implant design resulted in bone loss that was more severe than that associated with properly placed conventional dental implants. Further, the design showed no evidence of exceptional capacity to increase or maintain soft tissue height.
authors: Dental Science Center, University of Southern California School of Dentistry, 925 West 34th Street, Los Angeles, CA 90089, USA. nowzari@usc.edu
authors: Hessam
authors: H
authors: Nowzari
authors: Winston
authors: W
authors: Chee
authors: Klaus
authors: K
authors: Yi
authors: Mark
authors: M
authors: Pak
authors: Woun Ho
authors: WH
authors: Chung
authors: Sandra
authors: S
authors: Rich