Caroliene Meijndert

162 Addendum recession was 0.14±0.40 mm, and the median PES and WES were 6 [4;7] and 8 [7;8.3], respectively. The participants’ mean overall satisfaction was 90.1±6.5 on a 0-100 VAS. We can conclude that bone level tapered implants perform well in anterior maxillary healed sites, with respect to implant stability, based on clinical, aesthetic, radiographic and patient centred outcomes during a one-year follow-up. The performance of bone level tapered implants in the maxillary aesthetic zone was also evaluated clinically, radiographically and aesthetically after one year in sites where alveolar ridge preservation was applied ( Chapter 5 ). Thirty patients (16 male, 14 female, mean age 43 years) with a failing tooth and a large bone defect after tooth removal, received alveolar ridge preservation. After three months, implants were placed with immediate provisionalization. The definitive restorations were placed after 3 months. All the patients attended the one-year follow-up. One implant was lost (96.7% implant survival rate). The mean Implant Stability Quotient value was 68.9±8.74 at implant placement. The mean marginal bone level change was minor (-0.07±0.12 mm). The mean mid-buccal mucosa change was +0.01±0.45 mm. The median PES and WES were 6 [4;7] and 8 [7;9], respectively, after one year. The patients’ mean overall satisfaction (0-100 VAS scale) was 86.6±10.3. It can be concluded that bone level tapered implants, with immediate provisionalization, perform well after alveolar ridge preservation in the maxillary aesthetic zone, with respect to implant stability, and clinical, radiographic, aesthetic and patient-centred outcomes. The alleged benefit of tapered implants, compared to cylindrical implants, is the enhanced primary stability in soft bone and in extraction sockets. The tapered shape and self-cutting threads, combined with under drilling the implant bed during the osteotomy, make this implant type suitable for challenging sites. In the case report described in chapter 6 , the clinical, radiographic, aesthetic and patient centred outcomes of a new implant system designed for an immediate implant placement and restoration approach, to replace a single tooth in the anterior maxillary region, was assessed. Three cases were treated with a bone level tapered implant. All the patients were treated with the same strategy involving flapless extraction and implant placement with simultaneous augmentation. The implants were provisionally restored with a screw-retained restoration at the day of the surgery. A definitive restoration was fabricated after three months. At the one year follow-up after the definitive restoration, the implants were stable and no complications had occurred. The peri-implant bone levels had increased with a mean value of 0.24±0.30mm between definitive restoration placement and the 1 year follow-up. The clinical outcome scores showed healthy soft tissues. The mean PES and WES were 7.0 and 7.3, respectively. The mean patient