Caroliene Meijndert

105 Immediate placement and restoration of a new tapered implant system in the aesthetic region Two weeks after implant placement and temporary provisionalization, the patients were recalled for check-up ( Figure 4b ). None of the patients reported pain at the time of recall and only one patient reported having a bruised feeling at the day of implant surgery and one patient reported to have lost a few granulation particles but no major dehiscence was present. After a 3 months healing period, an open tray implant level impression was made with a polyether precision impression material (Impregum Penta; 3 M ESPE, St. Paul, USA) for the purpose of a definitive restoration. The definitive restoration consisted of a titanium base with zirconium structure and porcelain crown. When the restoration was completed and patients were satisfied the crown was placed and tightened to 35Ncm torque and oral hygiene instruction were given. Patients were followed for 12 months after final crown placement ( Figure 4c,4d ). a b c d Figure 4. A control CBCT at the day of implant placement. b Temporary crown 2weeks after placement. c, d: radiographic and clinical image 12 months after definitive crown placement Follow-up Recall was at 1 month (T 1 ) and 12 months (T 12 ) after the final restoration was placed. On these follow-up appointments, x-rays were made and clinical variables were measured. Bone level change was measured on a peri-apical radiograph on the mesial and distal side of the implant by drawing a line from the implant shoulder to the first bone to implant contact point. Change in midbuccal gingiva level was measured by drawing a (horizontal) line from the top of the midbuccal zenith of both natural lateral incisors and a second (vertical) line was drawn, perpendicular from the horizontal line to the mid buccal zenith of the tooth/implant crown. The length of this vertical line was measured (see figure 5). A periodontal probe was held close to, and parallel to the long axis of the implant crown, and was used as a calibration (Zuiderveld et al., 2018). 6