Caroliene Meijndert

46 Chapter 3 (SynOcta® Titanium Post for Temporary Restorations, Institut Straumann AG, Basel, Switserland) and composite resin (Solidex, Shofu, Higashiyama-Ku, Kyoto, Japan) was then made and screwed onto the implant (torqued to 35Ncm) and patients were given oral hygiene instructions. The patients received a final restoration three months later: an individually designed full-zirconia abutment, without a titanium interface, with a porcelain crown, either cemented or screwed onto the implant, depending on the position of the screw access hole. Twenty-seven restorations were cement-retained and 33 restorations were screw-retained. In case of a cemented restoration, a zirconia coping was veneered with porcelain (E.max Ceram, Ivoclar Vivadent, Liechtenstein) and cemented with glass ionomer cement (Fuji Plus; GC Europe, Leuven, Belgium). In case of a screw-retained restoration, porcelain (E.max Ceram) was directly fused to the abutment. Abutment screws were torqued to 35 Ncm. Outcome measures Clinical, radiographic and patient centred variables were collected before implant placement (T 0 ), 1 month (T 1 ), 1 year (T 12 ) and 5 years (T 60 ) after loading with the final restoration. Outcome measures were change in peri-implant marginal bone level, survival rate of the implant and crown, clinical variables, aesthetic outcome and patient satisfaction. Figure 1. Method of measuring peri-implant bone level on an intraoral radiograph. A line was drawn from the implant shoulder to the first bone-to-implant contact on the mesial and distal side. The length of the implant body was used for calibration.