title: Performance of the Straumann Bone Level Implant system for anterior single-tooth replacements in augmented and nonaugmented sites: a prospective cohort study with 60 consecutive patients.
abstract: OBJECTIVE
  The purpose of this prospective study was to evaluate radiographic, clinical and aesthetic outcomes and patient satisfaction of cases treated with platform-switched single implant restorations in the aesthetic region of the maxilla. Furthermore, the influence of an augmentation procedure 3 months before implant placement and the type of restoration (screw-retained vs. cement-retained) was evaluated.
  
  
  METHODS
  Sixty patients with a missing anterior tooth in the maxilla were treated with a Straumann Bone Level Implant. Bone augmentation was performed in 29 patients at 3 months before implant placement. Implants were loaded after 3 months of submerged healing. Follow-up was conducted at 7 and 18 months after implant placement. Peri-implant mucosa and implant crown aesthetic outcomes were determined using the Implant Crown Aesthetic Index (ICAI) and the Pink Esthetic Score-White Esthetic Score (PES-WES).
  
  
  RESULTS
  No implants were lost. At 18 months after implant placement, mean bone level change was -0.10 ± 0.27 mm and mean probing pocket depth was 2.57 mm. No differences were found between augmented and nonaugmented sites (P = 0.28). The ICAI indicated satisfactory mucosa and crown aesthetics in 67% and 75% of the cases, respectively, while the PES score was 14.4. ICAI mucosa (P = 0.004) and PES (P = 0.02) scores were significantly less favourable for augmented sites compared with nonaugmented sites. Patient satisfaction was high (8.9 ± 1.1 on VAS-score).
  
  
  CONCLUSIONS
  From the present prospective, clinical study, it can be concluded that the Straumann Bone Level Implant shows an excellent survival rate, marginal bone stability and good clinical and aesthetic results. Bone augmentation before implant placement does not lead to more marginal bone loss. However, less favourable pink aesthetic outcomes were found in augmented sites compared with nonaugmented sites, while no differences were found between cement-retained and screw-retained restorations.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. h.j.santing@umcg.nl
authors.forename: Hendrik J
authors.initials: HJ
authors.lastname: Santing
authors.forename: Gerry M
authors.initials: GM
authors.lastname: Raghoebar
authors.forename: Arjan
authors.initials: A
authors.lastname: Vissink
authors.forename: Laurens
authors.initials: L
authors.lastname: den Hartog
authors.forename: Henny J A
authors.initials: HJ
authors.lastname: Meijer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000145:classification; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D002484:Cementation / Q000379:methods; D015331:Cohort Studies; D003442:Crowns; D059605:Dental Implant-Abutment Design; D003758:Dental Implantation, Endosseous / Q000379:methods; D019250:Dental Implants, Single-Tooth; D003773:Dental Plaque / Q000145:classification; D017268:Dental Prosthesis Retention / Q000295:instrumentation / Q000379:methods; D004955:Esthetics, Dental; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000473:pathology; D005884:Gingival Hemorrhage / Q000145:classification; D005889:Gingival Recession / Q000145:classification; D006801:Humans; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D017060:Patient Satisfaction; D010514:Periodontal Pocket / Q000145:classification; D011446:Prospective Studies; D011859:Radiography; D016896:Treatment Outcome; D055815:Young Adult