title: Immediate placement and loading of maxillary single-tooth implants: a 3-year prospective study of marginal bone level.
abstract: OBJECTIVE
  The purpose of this study was to evaluate marginal bone level around single-tooth implants placed in anterior maxilla and immediately restored.
  
  
  METHODS
  Twenty implants were placed in 20 patients (8 men and 12 women) that were selected for this study. Following atraumatic non-surgical extraction of tooth, all patients immediately received implants and the definitive prefabricated abutment was placed. Implant position was transferred to the scanning unit of the CAD/CAM system using prefabricated surgical guide. Temporary crowns were immediately fabricated and cemented. Eight weeks later final crowns were luted. Outcome assessment as implant survival and level of marginal bone radiographic evaluations were performed at 8 weeks, 1 and 3 years time period after loading.
  
  
  RESULTS
  All implants placed osseointegrated successfully after 3 years of functional loading. The mean marginal bone loss was 0.16 mm (SD, 0.167 mm), 0.275 mm (SD, 0.171 mm) and 0.265 mm (SD, 0.171 mm) at 8 weeks, 1 and 3 years time period respectively. Four out of the 20 implants showed no bone loss.
  
  
  CONCLUSIONS
  Immediate loading technique using the final abutment directly eliminated the need for a second stage surgery and prevented interruption of soft and hard tissue at implant neck, which resulted in better soft tissue response and reduced marginal bone loss. Clinical significance: Immediately loaded implants, in fresh extraction sockets by insertion of a provisional restoration on the titanium abutment without any later manipulation, helped to protect the initially forming blood clot and presented a template for soft tissue contouring that resulted in significant reduction of marginal bone resorption and maintenance of soft tissue architecture.
authors.affiliation: Associate Professor and Chairperson, Department of Oral and Maxillofacial Surgery, School of Dentistry, Lebanese University, Lebanon.
authors.forename: Antoine N
authors.initials: AN
authors.lastname: Berberi
authors.affiliation: Lecturer and Director, Postgraduate Program, Department of Oral and Maxillofacial Surgery, School of Dentistry, Lebanese University, Lebanon.
authors.forename: Ziad N
authors.initials: ZN
authors.lastname: Noujeim
authors.affiliation: Clinical Instructor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Lebanese University, Lebanon.
authors.forename: Wasf H
authors.initials: WH
authors.lastname: Kanj
authors.affiliation: Clinical Instructor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Lebanese University, Lebanon.
authors.forename: Rita J
authors.initials: RJ
authors.lastname: Mearawi
authors.affiliation: Associate Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Lebanese University, Lebanon.
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Salameh
mesh_terms: D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging*; D000539:Alveolar Process / Q000000981:diagnostic imaging; D017076:Computer-Aided Design; D054893:Cone-Beam Computed Tomography / Q000379:methods; D003442:Crowns; D059605:Dental Implant-Abutment Design; D003758:Dental Implantation, Endosseous / Q000379:methods*; D019250:Dental Implants, Single-Tooth; D019094:Dental Prosthesis, Implant-Supported; D003794:Dental Restoration, Temporary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D057893:Immediate Dental Implant Loading; D008297:Male; D008437:Maxilla / Q000601:surgery*; D016348:Osseointegration / Q000502:physiology; D011446:Prospective Studies; D016019:Survival Analysis; D014081:Tooth Extraction / Q000379:methods; D020390:Tooth Socket / Q000601:surgery; D016896:Treatment Outcome