Caroliene Meijndert

61 Bone level tapered implants in the maxillary aesthetic zone Introduction There is a wide range of implant designs that can be used for singe-tooth replacement. One of these designs is an implant with a tapered body. Compared to a parallel-walled implant body, tapered implants have the alleged clinical benefits of, for example, less risk of apical bone fenestrations due to bony undercuts, which are commonly seen in the maxillary alveolar processus (Buser et al., 2004), and improved primary stability compared to parallel-walled implants (Atieh et al., 2018; Sugiura et al., 2019). When the alveolus is left to heal without bone preservative measures after a tooth is extracted, the buccal bone wall is subject to progressive physiologic resorption (Araújo et al., 2019). The resorption pattern can lead to a deficient labial bone wall and can compromise proper soft tissue support (Merheb, 2014; Araújo et al., 2015; Chappuis et al., 2017). Techniques have been described to avert this ‘physiologic collapse’ of the alveolar ridge, such as socket preservation, either with or without immediate implant placement (Jung et al., 2018; Araújo et al., 2019). It is particularly important to preserve the alveolar processes in the aesthetic region. The alveolar bone supports the mucosa and this determines a great deal of the aesthetic outcome of an implant restoration (Buser et al., 2004). Although recommendations are manifest, implant treatment is not always part of the restoration plan at the time of tooth extraction, and immediate implant placement or alveolar ridge preservation is therefore not carried out. It has been demonstrated that if implant treatment does become an option at a later stadium, guided bone regeneration, to augment the deficient bone wall, successfully increases the contour of bone and soft tissues (Chappuis et al., 2018; Wessing et al., 2018). Different brands of tapered implants are available. The results of placing these implants in the aesthetic region are good regarding implant survival, bone level change and aesthetic outcome, both in preserved and in non-preserved sites (Den Hartog et al., 2013; Cosyn et al., 2015; Slagter et al., 2016). In 2015, a new line of tapered implants was launched (Straumann Bone Level Tapered implant, Institut Straumann AG, Basel, Switzerland). This implant is equipped with the successful characteristics established by previous studies (Smeets et al., 2016; Hsu et al., 2017), such as SLActive surface and platform switching with a conical implant/abutment connection, but it also has a tapered body which means it is more applicable for challenging anatomical sites and for enhanced primary stability in soft bone or extraction sockets. To the best our knowledge, only a few studies have published about the use of this BLT implant system (Caiazzo et al., 2019; Levine et al., 2019; Pariente et al., 2020). Of these, only one describes placement specifically in the anterior maxilla. However, 4