Caroliene Meijndert

35 Single implants in the aesthetic region preceded by local ridge augmentation Plaque index, Bleeding index and Gingiva index scores were at the healthy end of the spectrum. Apparently, method of augmentation has no influence on the short and long-term clinical outcome of the treatments applied in this study. Probing depth at the buccal site was at all evaluation periods significantly deeper in the group with a bone substitute compared to the chin bone groups. An explanation for this phenomenon could not be found in the literature. A reason could be that the bone substitute has not fully been converted into bone over time and that the periodontal probe penetrates the substitute material. The electronic Paro-Probe® was not available anymore for the 10-years’ evaluation. The Paro-Probe® has a standardized probing pressure of 0.25N. In the search for a probe with a comparable standardized pressure force and a comparable flexibility of the tip, the Click-Probe® has been chosen as a reasonable alternative. Nevertheless, there could be a slight difference and this change in device is a possible limitation. Mean marginal bone loss after 10 years for the total group was 0.48 mm at the mesial side of the implant and 0.30 mm at the distal side, with no significant differences between the groups. Jemt (2008) reported a mean marginal bone loss of 0.66 mm and Gotfredsen (2012) reported mean bone loss of 0.75 mm after 10 years. These numbers are well in line with the present study. It seems that healthy peri-implant soft tissues are accompanied by limited peri-implant bone loss. Mean marginal gingival levels appeared to be very stable during the 10-year evaluation period. Mean mid-buccal recession of marginal mucosa was 0.3 mm, whereas approximal mucosa levels increased 0.5 mm. No significant differences between the groups were calculated. Only in the study of Schropp & Isidor (2015) marginal approximal gingiva levels were evaluated over 10 years, although using different parameters. Also in this study a gain in papilla height was found. Combining the results of marginal bone and gingival levels, it appears that a very stable situation was reached after finalizing the treatment. It seems that this is comparable with situations in which not a bone augmentations is needed. However, it is not known what the resorption rate of the augmentation materials was during the subsequent healing periods. The overall score of the ICAI at T 120 was 5.8, with an acceptable result for 59% of the patients. At T 12 this was respectively 4.8 and 66%. In none of the mentioned 10-year studies an aesthetic rating system was used. Mucosa scored less favourable than the crown, this is probably related to the initial situation: all patients presented with a large bone deficiency, making a bucco-palatinal local ridge augmentation necessary. It is known that the need for a bone augmentation procedure influences the aesthetic result negatively (Santing et al., 2013). The slight progression of gingival recession resulted 2