Long-term results of immediately inserted and provisionalized OsseoSpeed Profile implants in the esthetic zone

Background

The majority of the implants on the market has a flat prosthetic shoulder which does not correspond to the vertical height differences of the extraction socket walls. An implant with a sloped marginal shoulder, the Astra Tech OsseoSpeed Profile (Astra Tech AB, Mölndal, Sweden), has been developed 10 years ago to optimize implant placement in extraction sites and support the marginal bone circumferentially.

Aim/Hypothesis

The study examined the clinical performance of OsseoSpeed Profile implants in a one-stage procedure with immediate insertion and provisionalization in the esthetic zone within a follow-up of up to 8 year.

Material and Methods

Of 21 OsseoSpeed Profile implants were inserted in 16 patients. All implants were placed immediately into extraction sockets in the esthetic zone. Facial bony defects (4 total, 9 partial losses of the facial lamella) were reconstructed immediately with autogenous bone chips without raising a flap. All patients received immediate provisional restorations. Primary outcome variables were implant survival, marginal bone levels and Pink Esthetic Score.

Results

Mean follow-up was 99 months (range 82 to 107 months). One implant was lost early at 2.5 months. Two patients with 2 implants did not continue the follow-up after prosthesis delivery respectively the 3-year follow-up (drop-out). Cumulative survival rate according to Kaplan-Meier was 94.7%. Marginal bone levels remained at the level of the implant shoulder (0.01 ± 0.68, range, −0.9 to 2.2 mm) at the final follow-up. In 72% of the implant sites the gingival esthetics was stable or even improved from the pre-operative examination (mean 10.6 ± 2.3) to the final follow-up (mean 11.9 ± 1.5). The width of the attached mucosa and the gingival biotype correlated with the marginal bone levels and the gingival esthetics.

Conclusion and Clinical Implications

Results of survival rate, marginal bone and esthetic stability suggest proof of principle for immediate insertion and provisionalization of Astra OsseoSpeed Profile implants in the long-term observation.