Caroliene Meijndert

152 Chapter 8 Although the studies described in this thesis, as well as the other studies in the literature, report satisfying results for single-tooth replacement in the aesthetic zone, this treatment is a complex procedure influenced by numerous factors such as pre- treatment status, surgical techniques (flap/flapless, hard/soft tissue augmentation, placement protocol), implant characteristics (surface properties, thread and neck design, abutment connection configuration) and patient characteristics ((micro) biological and oral hygiene). More insight will be gained through further research and continuous evaluation of innovations leading to a high quality restoration that is functional, stable and aesthetically pleasing in the short and long term. Conclusions Based on the various studies described in this thesis, the following specific conclusions can be drawn: − Pre-implant augmentation of a bone defect in the anterior region with either chinbone or a demineralised bovine bone substitute, followed by tissue level implant treatment, results in favourable 10-year clinical, radiographic and aesthetic outcomes, and satisfied patients ( Chapter 2 ); − Bone level parallel-walled implants result in favourable 5-year results, for single tooth replacement in the maxillary aesthetic zone, with respect to clinical, radiographic, aesthetic and patient centered outcome. ( Chapter 3 ); − Bone level tapered implants in unassisted healed maxillary sites, with a delayed loading protocol, result in favourable outcomes with respect to implant stability, and clinical, aesthetic, radiographic and patient-centred outcomes ( Chapter 4 ); − Bone level tapered implants, applied in the maxillary aesthetic region after alveolar ridge preservation, and in combination with immediate provisionalization, are accompanied with a high survival rate, stable marginal bone levels and soft tissue levels, good aesthetic outcomes and high patient satisfaction 1 year after implant placement ( Chapter 5 ); − Immediate implant placement and provisionalization using an implant systemwith self-cutting edges has the potential to result in favourable clinical, radiographic, aesthetic and patient satisfaction outcomes ( Chapter 6 ); − The performance of conical and parallel platform-switched connection configurations, when applied to solitary implant restorations in the aesthetic zone is comparable with regard to peri-implant bone loss ( Chapter 7 );