Caroliene Meijndert

47 Performance of bone level implants with conical connections in the anterior maxilla − Bone level change was recorded on standardised radiographs according to the method developed by Meijndert and colleagues (Meijndert et al., 2004). Measurements were done by a trained observer with a high intra-rater reliability score (ICC 0.98 [0.96-0.98] with 95% CI). A line was drawn from the implant shoulder to the first bone-to-implant contact on the mesial and distal side (Figure 1). Mean change was calculated with the least favourable change of the mesial and distal site to avoid an underestimation of the bone level change. A negative value indicates bone loss. − Survival of the implant and crown was assessed as positive when the implant or crown was present, immobile, and no progressive bone loss, infection or fracture leading to removal was reported. − Clinical variables were assessed using the Modified Plaque Index (Mombelli et al., 1987), Modified Sulcus Bleeding Index (Mombelli et al., 1987) and Papilla Index (Jemt, 1997). The pocket probing depth was measured to the nearest 1 mm using a periodontal Click-probe® with a standard pressure of 0.2-0.25N (KerrHawe Dental Corporation, Bioggio, Switzerland). − Aesthetic outcome , using the modified Pink and White Esthetic Score (PES-WES) (Belser et al., 2009), was assessed by an experienced prosthodontist who was trained with the index and blinded for the applied treatment procedures. − Peri-implant mucositis and peri-implantitis were assessed according to the definition composed at the Seventh European Workshop on Periodontology (Lang & Berglundh, 2011) describing peri-implant mucositis as: bleeding on probing and/ or suppuration but <2mm radiographic bone loss. Peri-implantitis was described as bleeding on probing and/or suppuration in combination with radiographic bone loss ≥2mm. − Patient satisfaction was determined with a self-administered 5-point Likert-type questionnaire (Den Hartog et al., 2013) focussing on the colour and form of the crown and the colour and form of the peri-implant mucosa, ranging from very dissatisfied (score 1) to very satisfied (score 5). Specific questions were: − How satisfied are you with the form of the crown on the implant? − How satisfied are you with the colour of the crown on the implant? − How satisfied are you with the form of the gums around the implant? − How satisfied are you with the colour of the gums around the implant? − Overall satisfaction was noted on a 100mm VAS-scale ranging from ‘very dissatisfied’ at the outer left side to ‘very satisfied’ at the outer right side. 3