title: Submerged and transmucosal healing yield the same clinical outcomes with two-piece implants in the anterior maxilla and mandible: interim 1-year results of a randomized, controlled clinical trial.
abstract: OBJECTIVE
  To test whether or not transmucosal healing at two-piece implants is as successful as submerged placement regarding crestal bone levels and patient satisfaction.
  
  
  METHODS
  Adults requiring implants in the anterior maxilla or mandible in regions 21-25, 11-15, 31-35 or 41-45 (WHO) were recruited for this randomized, controlled multi-center clinical trial of a 5-year duration. Randomization was performed at implantation allowing for either submerged or transmucosal healing. Final reconstructions were seated 6 months after implantation. Radiographic interproximal crestal bone levels and peri-implant soft tissue parameters were measured at implant placement (IP) (baseline), 6 and 12 months. Patient satisfaction was assessed by a questionnaire. A two-sided t-test (80% power, significance level α=0.05) was performed on bone-level changes at 6 and 12 months.
  
  
  RESULTS
  One hundred and twenty-seven subjects were included in the 12-month analysis (submerged [S]: 52.5%, transmucosal [TM]: 47.2%). From IP to 6 months, the change in the crestal bone level was -0.32 mm (P<0.001) for the S group and -0.29 mm (P<0.001) for the TM group. From IP to 12 months, bone-level changes were statistically significant in both groups (S -0.47 mm, P<0.001; TM -0.48 mm, P<0.001). The mean differences of change in the bone levels between the two groups were not statistically significant at either time point, indicating the equivalence of both procedures. For both groups, very good results were obtained for soft tissue parameters and for patient satisfaction.
  
  
  CONCLUSIONS
  Transmucosal healing of two-piece implants is as successful as the submerged healing mode with respect to tissue integration and patient satisfaction within the first 12 months after IP.
authors: Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, SwitzerlandDepartment of Periodontology, Universidad Complutense de Madrid, Madrid, SpainBalwyn Periodontic Centre, School of Dental Science, University of Melbourne, Melbourne, AustraliaDepartment of Prosthodontics, College of Dentistry, University of Florida, Gainesville, FL, USADepartment of Oral Surgery and Dental Emergency Care, Faculty of Health, University Witten/Herdecke, Witten, GermanyDepartment of Oral and Maxillofacial Surgery, SU/Mölndal Hospital, Mölndal and the Sahlgrenska Academy, Göteborg University, Mölndal, SwedenDepartment of Periodontology and Prosthodontics, Eastman Dental Hospital, Rome, ItalyFlorida Institute for Periodontics and Dental Implants, Boca Raton, FL, USADepartment of Oral, Maxillo and Facial Plastic Surgery, Center for Implant Dentistry, Klinikum Stuttgart, GermanyDepartment of Oral and Maxillofacial Surgery, University of Schleswig-Holstein, Kiel, GermanyPrivate Dental Clinic, Munich, Germany.
authors: Christoph H F
authors: CHF
authors: Hämmerle
authors: Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, SwitzerlandDepartment of Periodontology, Universidad Complutense de Madrid, Madrid, SpainBalwyn Periodontic Centre, School of Dental Science, University of Melbourne, Melbourne, AustraliaDepartment of Prosthodontics, College of Dentistry, University of Florida, Gainesville, FL, USADepartment of Oral Surgery and Dental Emergency Care, Faculty of Health, University Witten/Herdecke, Witten, GermanyDepartment of Oral and Maxillofacial Surgery, SU/Mölndal Hospital, Mölndal and the Sahlgrenska Academy, Göteborg University, Mölndal, SwedenDepartment of Periodontology and Prosthodontics, Eastman Dental Hospital, Rome, ItalyFlorida Institute for Periodontics and Dental Implants, Boca Raton, FL, USADepartment of Oral, Maxillo and Facial Plastic Surgery, Center for Implant Dentistry, Klinikum Stuttgart, GermanyDepartment of Oral and Maxillofacial Surgery, University of Schleswig-Holstein, Kiel, GermanyPrivate Dental Clinic, Munich, Germany.
authors: Ronald E
authors: RE
authors: Jung
authors: Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, SwitzerlandDepartment of Periodontology, Universidad Complutense de Madrid, Madrid, SpainBalwyn Periodontic Centre, School of Dental Science, University of Melbourne, Melbourne, AustraliaDepartment of Prosthodontics, College of Dentistry, University of Florida, Gainesville, FL, USADepartment of Oral Surgery and Dental Emergency Care, Faculty of Health, University Witten/Herdecke, Witten, GermanyDepartment of Oral and Maxillofacial Surgery, SU/Mölndal Hospital, Mölndal and the Sahlgrenska Academy, Göteborg University, Mölndal, SwedenDepartment of Periodontology and Prosthodontics, Eastman Dental Hospital, Rome, ItalyFlorida Institute for Periodontics and Dental Implants, Boca Raton, FL, USADepartment of Oral, Maxillo and Facial Plastic Surgery, Center for Implant Dentistry, Klinikum Stuttgart, GermanyDepartment of Oral and Maxillofacial Surgery, University of Schleswig-Holstein, Kiel, GermanyPrivate Dental Clinic, Munich, Germany.
authors: Mariano
authors: M
authors: Sanz
authors: Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, SwitzerlandDepartment of Periodontology, Universidad Complutense de Madrid, Madrid, SpainBalwyn Periodontic Centre, School of Dental Science, University of Melbourne, Melbourne, AustraliaDepartment of Prosthodontics, College of Dentistry, University of Florida, Gainesville, FL, USADepartment of Oral Surgery and Dental Emergency Care, Faculty of Health, University Witten/Herdecke, Witten, GermanyDepartment of Oral and Maxillofacial Surgery, SU/Mölndal Hospital, Mölndal and the Sahlgrenska Academy, Göteborg University, Mölndal, SwedenDepartment of Periodontology and Prosthodontics, Eastman Dental Hospital, Rome, ItalyFlorida Institute for Periodontics and Dental Implants, Boca Raton, FL, USADepartment of Oral, Maxillo and Facial Plastic Surgery, Center for Implant Dentistry, Klinikum Stuttgart, GermanyDepartment of Oral and Maxillofacial Surgery, University of Schleswig-Holstein, Kiel, GermanyPrivate Dental Clinic, Munich, Germany.
authors: Stephen
authors: S
authors: Chen
authors: Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, SwitzerlandDepartment of Periodontology, Universidad Complutense de Madrid, Madrid, SpainBalwyn Periodontic Centre, School of Dental Science, University of Melbourne, Melbourne, AustraliaDepartment of Prosthodontics, College of Dentistry, University of Florida, Gainesville, FL, USADepartment of Oral Surgery and Dental Emergency Care, Faculty of Health, University Witten/Herdecke, Witten, GermanyDepartment of Oral and Maxillofacial Surgery, SU/Mölndal Hospital, Mölndal and the Sahlgrenska Academy, Göteborg University, Mölndal, SwedenDepartment of Periodontology and Prosthodontics, Eastman Dental Hospital, Rome, ItalyFlorida Institute for Periodontics and Dental Implants, Boca Raton, FL, USADepartment of Oral, Maxillo and Facial Plastic Surgery, Center for Implant Dentistry, Klinikum Stuttgart, GermanyDepartment of Oral and Maxillofacial Surgery, University of Schleswig-Holstein, Kiel, GermanyPrivate Dental Clinic, Munich, Germany.
authors: William C
authors: WC
authors: Martin
authors: Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, SwitzerlandDepartment of Periodontology, Universidad Complutense de Madrid, Madrid, SpainBalwyn Periodontic Centre, School of Dental Science, University of Melbourne, Melbourne, AustraliaDepartment of Prosthodontics, College of Dentistry, University of Florida, Gainesville, FL, USADepartment of Oral Surgery and Dental Emergency Care, Faculty of Health, University Witten/Herdecke, Witten, GermanyDepartment of Oral and Maxillofacial Surgery, SU/Mölndal Hospital, Mölndal and the Sahlgrenska Academy, Göteborg University, Mölndal, SwedenDepartment of Periodontology and Prosthodontics, Eastman Dental Hospital, Rome, ItalyFlorida Institute for Periodontics and Dental Implants, Boca Raton, FL, USADepartment of Oral, Maxillo and Facial Plastic Surgery, Center for Implant Dentistry, Klinikum Stuttgart, GermanyDepartment of Oral and Maxillofacial Surgery, University of Schleswig-Holstein, Kiel, GermanyPrivate Dental Clinic, Munich, Germany.
authors: Jochen
authors: J
authors: Jackowski
authors: Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, SwitzerlandDepartment of Periodontology, Universidad Complutense de Madrid, Madrid, SpainBalwyn Periodontic Centre, School of Dental Science, University of Melbourne, Melbourne, AustraliaDepartment of Prosthodontics, College of Dentistry, University of Florida, Gainesville, FL, USADepartment of Oral Surgery and Dental Emergency Care, Faculty of Health, University Witten/Herdecke, Witten, GermanyDepartment of Oral and Maxillofacial Surgery, SU/Mölndal Hospital, Mölndal and the Sahlgrenska Academy, Göteborg University, Mölndal, SwedenDepartment of Periodontology and Prosthodontics, Eastman Dental Hospital, Rome, ItalyFlorida Institute for Periodontics and Dental Implants, Boca Raton, FL, USADepartment of Oral, Maxillo and Facial Plastic Surgery, Center for Implant Dentistry, Klinikum Stuttgart, GermanyDepartment of Oral and Maxillofacial Surgery, University of Schleswig-Holstein, Kiel, GermanyPrivate Dental Clinic, Munich, Germany.
authors: Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, SwitzerlandDepartment of Periodontology, Universidad Complutense de Madrid, Madrid, SpainBalwyn Periodontic Centre, School of Dental Science, University of Melbourne, Melbourne, AustraliaDepartment of Prosthodontics, College of Dentistry, University of Florida, Gainesville, FL, USADepartment of Oral Surgery and Dental Emergency Care, Faculty of Health, University Witten/Herdecke, Witten, GermanyDepartment of Oral and Maxillofacial Surgery, SU/Mölndal Hospital, Mölndal and the Sahlgrenska Academy, Göteborg University, Mölndal, SwedenDepartment of Periodontology and Prosthodontics, Eastman Dental Hospital, Rome, ItalyFlorida Institute for Periodontics and Dental Implants, Boca Raton, FL, USADepartment of Oral, Maxillo and Facial Plastic Surgery, Center for Implant Dentistry, Klinikum Stuttgart, GermanyDepartment of Oral and Maxillofacial Surgery, University of Schleswig-Holstein, Kiel, GermanyPrivate Dental Clinic, Munich, Germany.
authors: Carl-Johan
authors: CJ
authors: Ivanoff
authors: Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, SwitzerlandDepartment of Periodontology, Universidad Complutense de Madrid, Madrid, SpainBalwyn Periodontic Centre, School of Dental Science, University of Melbourne, Melbourne, AustraliaDepartment of Prosthodontics, College of Dentistry, University of Florida, Gainesville, FL, USADepartment of Oral Surgery and Dental Emergency Care, Faculty of Health, University Witten/Herdecke, Witten, GermanyDepartment of Oral and Maxillofacial Surgery, SU/Mölndal Hospital, Mölndal and the Sahlgrenska Academy, Göteborg University, Mölndal, SwedenDepartment of Periodontology and Prosthodontics, Eastman Dental Hospital, Rome, ItalyFlorida Institute for Periodontics and Dental Implants, Boca Raton, FL, USADepartment of Oral, Maxillo and Facial Plastic Surgery, Center for Implant Dentistry, Klinikum Stuttgart, GermanyDepartment of Oral and Maxillofacial Surgery, University of Schleswig-Holstein, Kiel, GermanyPrivate Dental Clinic, Munich, Germany.
authors: Luca
authors: L
authors: Cordaro
authors: Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, SwitzerlandDepartment of Periodontology, Universidad Complutense de Madrid, Madrid, SpainBalwyn Periodontic Centre, School of Dental Science, University of Melbourne, Melbourne, AustraliaDepartment of Prosthodontics, College of Dentistry, University of Florida, Gainesville, FL, USADepartment of Oral Surgery and Dental Emergency Care, Faculty of Health, University Witten/Herdecke, Witten, GermanyDepartment of Oral and Maxillofacial Surgery, SU/Mölndal Hospital, Mölndal and the Sahlgrenska Academy, Göteborg University, Mölndal, SwedenDepartment of Periodontology and Prosthodontics, Eastman Dental Hospital, Rome, ItalyFlorida Institute for Periodontics and Dental Implants, Boca Raton, FL, USADepartment of Oral, Maxillo and Facial Plastic Surgery, Center for Implant Dentistry, Klinikum Stuttgart, GermanyDepartment of Oral and Maxillofacial Surgery, University of Schleswig-Holstein, Kiel, GermanyPrivate Dental Clinic, Munich, Germany.
authors: Jeffrey
authors: J
authors: Ganeles
authors: Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, SwitzerlandDepartment of Periodontology, Universidad Complutense de Madrid, Madrid, SpainBalwyn Periodontic Centre, School of Dental Science, University of Melbourne, Melbourne, AustraliaDepartment of Prosthodontics, College of Dentistry, University of Florida, Gainesville, FL, USADepartment of Oral Surgery and Dental Emergency Care, Faculty of Health, University Witten/Herdecke, Witten, GermanyDepartment of Oral and Maxillofacial Surgery, SU/Mölndal Hospital, Mölndal and the Sahlgrenska Academy, Göteborg University, Mölndal, SwedenDepartment of Periodontology and Prosthodontics, Eastman Dental Hospital, Rome, ItalyFlorida Institute for Periodontics and Dental Implants, Boca Raton, FL, USADepartment of Oral, Maxillo and Facial Plastic Surgery, Center for Implant Dentistry, Klinikum Stuttgart, GermanyDepartment of Oral and Maxillofacial Surgery, University of Schleswig-Holstein, Kiel, GermanyPrivate Dental Clinic, Munich, Germany.
authors: Dieter
authors: D
authors: Weingart
authors: Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, SwitzerlandDepartment of Periodontology, Universidad Complutense de Madrid, Madrid, SpainBalwyn Periodontic Centre, School of Dental Science, University of Melbourne, Melbourne, AustraliaDepartment of Prosthodontics, College of Dentistry, University of Florida, Gainesville, FL, USADepartment of Oral Surgery and Dental Emergency Care, Faculty of Health, University Witten/Herdecke, Witten, GermanyDepartment of Oral and Maxillofacial Surgery, SU/Mölndal Hospital, Mölndal and the Sahlgrenska Academy, Göteborg University, Mölndal, SwedenDepartment of Periodontology and Prosthodontics, Eastman Dental Hospital, Rome, ItalyFlorida Institute for Periodontics and Dental Implants, Boca Raton, FL, USADepartment of Oral, Maxillo and Facial Plastic Surgery, Center for Implant Dentistry, Klinikum Stuttgart, GermanyDepartment of Oral and Maxillofacial Surgery, University of Schleswig-Holstein, Kiel, GermanyPrivate Dental Clinic, Munich, Germany.
authors: Jörg
authors: J
authors: Wiltfang
authors: Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, SwitzerlandDepartment of Periodontology, Universidad Complutense de Madrid, Madrid, SpainBalwyn Periodontic Centre, School of Dental Science, University of Melbourne, Melbourne, AustraliaDepartment of Prosthodontics, College of Dentistry, University of Florida, Gainesville, FL, USADepartment of Oral Surgery and Dental Emergency Care, Faculty of Health, University Witten/Herdecke, Witten, GermanyDepartment of Oral and Maxillofacial Surgery, SU/Mölndal Hospital, Mölndal and the Sahlgrenska Academy, Göteborg University, Mölndal, SwedenDepartment of Periodontology and Prosthodontics, Eastman Dental Hospital, Rome, ItalyFlorida Institute for Periodontics and Dental Implants, Boca Raton, FL, USADepartment of Oral, Maxillo and Facial Plastic Surgery, Center for Implant Dentistry, Klinikum Stuttgart, GermanyDepartment of Oral and Maxillofacial Surgery, University of Schleswig-Holstein, Kiel, GermanyPrivate Dental Clinic, Munich, Germany.
authors: Michael
authors: M
authors: Gahlert
mesh_terms: D016301:Alveolar Bone Loss / Q000517:prevention & control*; D000540:Alveolar Ridge Augmentation; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D017267:Dental Prosthesis Design; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000601:surgery*; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D017060:Patient Satisfaction; D011859:Radiography; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*
chemical_list: D015921:Dental Implants