title: A 5-year prospective clinical study of submerged and nonsubmerged Paragon system implants in the edentulous mandible.
abstract: OBJECTIVE
  The aim of this investigation was to evaluate the clinical outcome of two different surgical protocols in the edentulous mandible: submerged and nonsubmerged. Further, the Paragon dental implant with a titanium plasma-sprayed surface was evaluated.
  
  
  METHODS
  Twenty-nine consecutively treated patients with 168 implants supporting fixed prostheses were included. All but 3 patients were provided 6 implants, placed via nonsubmerged healing on one side and submerged healing on the other. Data were collected from patient records and radiographs. Twenty-four patients participated in the 5-year clinical follow-up examination.
  
  
  RESULTS
  After 5 years, all patients still had their mandibular fixed prostheses in function. Cumulative survival rates were 100% for prostheses and 99.4% for implants. However, 3 implants fractured in 1 patient. One submerged implant was lost before loading but no further implants were lost during follow-up. The radiographic bone loss was small for all implants with a mean of 0.14 mm (standard deviation [SD]: 0.37) at 1 year and 0.42 mm (SD: 0.48) at 5 years for nonsubmerged implants and 0.17 mm (SD: 0.32) at 1 year and 0.51 mm (SD: 0.33) at 5 years for submerged implants. Nineteen implants (including the 3 that fractured) presented annual bone loss exceeding 0.2 mm after the first year, yielding a cumulative success rate of 86.2% after 5 years.
  
  
  CONCLUSIONS
  Single-stage surgery was shown to have the same predictability as two-stage surgery in the anterior edentulous mandible. Paragon implants with a titanium plasma-sprayed surface showed a fracture rate of 2.2% and a success rate of 86.2% after 5 years.
authors.affiliation: Department of Prosthetic Dentistry, Postgraduate Dental Education Center, Orebro, Sweden. alf.eliasson@orebroll.se
authors.forename: Alf
authors.initials: A
authors.lastname: Eliasson
authors.forename: Birger
authors.initials: B
authors.lastname: Narby
authors.forename: Karl
authors.initials: K
authors.lastname: Ekstrand
authors.forename: Jan
authors.initials: J
authors.lastname: Hirsch
authors.forename: Anders
authors.initials: A
authors.lastname: Johansson
authors.forename: Ann
authors.initials: A
authors.lastname: Wennerberg
mesh_terms: D000368:Aged; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000209:etiology; D020099:Coated Materials, Biocompatible / Q000737:chemistry; D000044:Dental Abutments; D003758:Dental Implantation, Endosseous / Q000009:adverse effects / Q000379:methods*; D015921:Dental Implants; D003764:Dental Materials / Q000737:chemistry; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007575:Jaw, Edentulous / Q000534:rehabilitation / Q000601:surgery*; D008297:Male; D008334:Mandible / Q000601:surgery*; D016348:Osseointegration / Q000502:physiology; D010518:Periodontitis / Q000209:etiology; D011446:Prospective Studies; D011859:Radiography; D016019:Survival Analysis; D014025:Titanium / Q000737:chemistry; D016896:Treatment Outcome
chemical_list: D020099:Coated Materials, Biocompatible; D015921:Dental Implants; D003764:Dental Materials; D014025:Titanium