Caroliene Meijndert

21 Single implants in the aesthetic region preceded by local ridge augmentation Introduction Single tooth replacement in the aesthetic region has been part of implant dentistry for a number of decades. Since its introduction many implant systems, surgical and prosthetic techniques, and loading protocols have been used (Den Hartog et al., 2008; Esposito et al., 2010; Jung et al., 2012; Lang et al., 2012; Benic et al., 2014; Slagter et al., 2014). Yet, most reported survival rates of single tooth implants and crowns are restricted to one year. From a systematic review of Jung et al. (2012) it can be learned that 5 and 10 years’ survival of implants supporting a single crown was 97.2% and 95.2%, respectively. The 5- and 10-years’ survival rate of the single crowns themselves were 96.3% and 89.4%, respectively. It must be noted, however that this meta-analysis was not limited to single tooth replacement specifically in the aesthetic region. The goal of dental implant therapy in the aesthetic region is to achieve successful tissue integration and predictable and aesthetic acceptable soft tissue contours, thus re-establishing both function and aesthetics. Favourable results should not just be a short-term result, but also be present after a long-term follow-up. Yet, a follow- up of ≥10 years of dental implants in the aesthetic region is limited to the studies of Jemt (2008), Gotfredsen (2012), Schropp & Isidor (2015) and Kuchler et al. (2016). Jemt studied 38 patients with 47 Branemark system implants (Nobel Biocare, Gothenburg, Sweden). Implant survival rate was 100%; crown survival rate was 77%. Gotfredsen studied 20 patients with 20 Astra Tech ST implants (Astra Tech AB, Mölndal, Sweden). Implant survival rate was 100%; crown survival rate was 90%. Schropp and Isidor (2015) studied 44 patients with 44 Osseotite implants (Biomet/3i, Palm Beach Gardens, FL, USA). Implant survival rate was 93.2%; crown survival rate was not reported. Kuchler et al.(2016) studied 17 patients with 17 Straumann Plus implants (Institut Straumann AG, Basel, Switzerland). Implant survival rate was 100%; crown survival rate was not reported. Only the latter study reported on hard and soft tissues as well as patient centred outcomes. Due to post-extraction resorption of the alveolar process or because of bone loss as a result of periodontal disease or trauma, it is not uncommon that insufficient bone volume is available to place implants in the anterior region and to obtain favourable aesthetics. Thus, pre-implant local ridge augmentation is commonly needed in these cases. Jung et al. (2013) presented 12–14 years’ outcomes of implants placed simultaneously with guided bone regeneration using resorbable and non-resorbable membranes. Fifty- eight patients, treated with 222 Branemark implants (Nobel Biocare, Gothenburg, Sweden) were evaluated. Implant surgery was performed without an augmentation 2