Caroliene Meijndert

24 Chapter 2 post; Institute Straumann AG, Basel, Switzeland) and veneering composite (Solidex, Shofu, Tokyo, Japan). On the day of uncovering of the implants, the temporary crown was placed to allow healing of the peri-implant mucosa against a tooth-shaped form. The temporary crowns were screwed directly onto the implant and tightened to 15 Ncm using a torque control device. One month later, a final crown was constructed. The final crown consisted of an abutment (RN synOcta® 1.5 mm abutment; Institute Straumann AG, Basel, Switzeland), a cast-on gold coping for contouring of an ideal emergence profile and adaptation of the margin to the mucosal contour (gold coping; Institute Straumann AG, Basel, Switzeland) and a porcelain crown with a zirkoniumoxide core (Procera®, NobelBiocare, Gothenburg, Sweden). The synOcta® abutment was screwed directly onto the implant with a tightening force of 35 Ncm, the gold coping was screwed onto the abutment with a tightening force of 15 Ncm and the porcelain crown was cemented onto the gold coping. Clinical and radiographic examinations Clinical assessments were performed at 1 month (T 1 ), 12 months (T 12 ) and 120 months (T 120 ) after placement of the final crown using Plaque index (Mombelli et al., 1987), Bleeding index (Mombelli et al., 1987) and Gingiva index (Löe & Silness, 1963). At T 120 pocket probing depth (Quirynen et al. 1991) was assessed using a clickprobe with standard probing pressure of 0.2–0.25N (Click-Probe®, KerrHawe Dental Corporation, Bioggio, Switzerland) which is equivalent to the electronic periodontal probe with standardized probing pressure of 0.25 ± 0.025N used at T 1 and T 12 (ParoProbe®, Estrad BV, Nieuwleusen, the Netherlands). Radiographic examination was performed using standardized intraoral radiographs. Marginal bone level (MBL) was measured mesially and distally at 1 month, 12 months and 120 months after final crown placement. At the same time points, colour slides were taken from the implant-supported crown and surrounding soft tissues. Mid-buccal and approximal marginal gingival level (MGL) was measured to the nearest 0.1 mm. Evaluation of aesthetics and patient satisfaction Aesthetics of implant crown and surrounding mucosa was assessed using the Implant Crown Aesthetic Index (ICAI). This index rates anatomic form, colour and surface characteristics of the crown and surrounding mucosa using a penalty system for minor and major deviations (Meijer et al., 2005). Assessment was done on colour slides of evaluation period T 12 and T 120 and was performed by the same prosthodontist who was trained with the index and blinded for the applied treatment procedure ( Figs 1, 2 and 3 ).