Caroliene Meijndert

65 Bone level tapered implants in the maxillary aesthetic zone − Implant stability, analysed by measuring the initial fixation (Implant Stability Quotient: ISQ) using an Osstell™ mentor device (Integration Diagnostics AB, Gothenburg, Sweden) (Sim& Lang, 2010; Sennerby &Meredith, 2008) immediately after implantation and right before placing the definitive restoration. − Probing depth. The implant was probed at four sites (mesial, distal, mid-buccal, mid-palatinal) and the 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). − Clinical variables. Modified Plaque index (Mombelli et al., 1987), Modified Sulcus Bleeding Index (Mombelli et al., 1987), Gingiva Index (Löe, 1967) and Papilla index (Jemt, 1997). − Aesthetic parameters were assessed with the modified Pink and White Esthetic Scores (PES/WES) (Belser et al., 2009). − Mid-buccal gingiva and papilla change (Zuiderveld et al., 2018) were measured on intra-oral color photographs using a periodontal probe parallel to, and in close proximity to, the axis of the implant crown for calibration (Williams Color- Coded probe; Hu-Friedy Chicago, IL, USA). A horizontal line was drawn between the incisal line of the adjacent teeth (reference line). The distance between the reference line and the mesial and distal papilla and the mid-buccal mucosal margin were measured and analysed (Adobe Photoshop 21.0.3 2020, Adobe Systems Inc., San Jose, USA). − Participant satisfaction was assessed with a questionnaire used by Den Hartog et al. (2013), completed prior to implant placement and one year after definitive crown placement. The questions focussed on the influence of the affected site or the new implant restoration on the patient’s self-confidence, function and aesthetics, and were answered on a 5-point scale, ranging from very dissatisfied or strongly disagree (score 1) to very satisfied or totally agree (score 5). The overall satisfaction was measured on a 0-100 Visual Analogue Scale (VAS). − Complications: Any biological and technical complication that occurred during the period prior to, and up to one year after definitive crown placement, were recorded. Statistical analysis Statistical analysis was performed to gain insight in data of clinical, radiographic and esthetic outcome scores and difference in patients satisfaction between the pre- operative situation and one year after definitive restoration placement. All the data 4