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Background Having laboratory technicians prepare soft-tissue casts and implant abutments with or without concomitant removable temporary prostheses during the restorative phase of single-tooth replacement is an accepted practice. It can, however, result in functional and esthetic intraoral discrepancies. Case Description Single-tooth implants can be restored with crowns (like those for natural teeth) fabricated at a dental laboratory on casts obtained from final impressions of prepared implant abutments. In the case reported, the restorative dentist restored the patient's single-tooth implant after taking a transfer impression. He constructed a cast simulating the peri-implant soft tissue with final impression material and prepared the abutment on this model. His dental assistant then fabricated a fixed provisional restoration on the prepared abutment. At the patient's next visit, the dentist torqued the prepared abutment onto the implant, took a final impression and inserted the provisional restoration. A crown was made conventionally at the dental laboratory and cemented in place at the following visit. Clinical Implications This alternative method for restoring single-tooth implants enhances esthetics by more accurately simulating marginal gingival architecture. It also improves function by preloading the implant through fixed temporization after the dentist, rather than the laboratory technician, prepares the abutment to the dentist's preferred contours.

The single-tooth implant has found widespread support within the field of implant dentistry, with numerous studies reporting high success rates that surpass those recorded for splinted implant bridgework. Improvements in implant design, range of prosthetic components and restorative materials have made it possible to achieve optimal functional and cosmetic results. Coupled with an appropriate approach to treatment planning and patient assessment, use of the single-tooth implant may be considered a highly predictable treatment solution.

Background: The success of osseointegrated implants ad modum Branemark for single-tooth restorations is documented. Future developments should aim at improving the benefits to patients by decreasing treatment time, minimizing surgical stages, and maximizing esthetic outcomes. Using knowledge from studies of immediate implant placement, one-stage, immediate loading protocols, the authors developed the immediate provisional. Purpose: The purpose of this study was to develop a protocol to provide an immediate solution for restoring a single missing tooth in the esthetic zone. The protocol should be simple, predictable, cost effective, and allow the use of other techniques to improve esthetic outcome. Materials and Method: This prospective clinical study included 24 patients treated from August 1999 to October 2000. Single-tooth implant replacement was done according to immediate provisional protocol. Thirteen of the 24 patients had immediate implant placement after tooth extraction. All implants were placed in the esthetic zone. During surgery, emphasis was placed on obtaining primary stability by achieving bicortical anchorage and maximum insertion torque of at least 40 Ncm. CeraOne (Nobel Biocare) abutments were used, and provisional crowns were fabricated immediately before wound closure. The occlusion was protected by adjacent teeth. Results: Within the follow-up period of between 1 month and 15 months, all fixtures in the 24 patients were stable. Crestal bone loss greater than one thread-width was not detected. The esthetic result was considered satisfactory by all patients. Conclusions: The implant placement and restoration protocol used in this study showed promising initial results for both the immediate implant and healed extraction site groups. The desirable goals of patient satisfaction, excellent esthetic outcomes, and no increase in treatment cost were achieved in this protocol. Further studies to elucidate the potential of the immediate provisional protocol are justified.

Aim— To evaluate the AstraTech Implant ST (Molndal, Sweden) for single tooth replacement clinically and radiographically after 5 years in function. Subjects and method— Fifteen patients (age range 16 to 48) with missing maxillary anterior teeth (6 central incisors, 8 laterals, 1 bicuspid) had four 13 mm and eleven 15 mm single tooth implants provided. All patients were seen at 4- to 6-monthly intervals for oral hygiene maintenance. Periapical radiographs using Rinn holders and a long cone technique were taken at the crown insertion and after 1 year, 3 and 5 years. Results— No implant losses were observed in 14 of the 15 patients available for evaluation. No abutment screw loosening or soft tissue problems were observed. At crown insertion the mean bone level was 0.46±0.55 to 0.48 ±0.56 mm apical to the top of the implant neck and there were no statistically significant changes in the radiographic bone level over the 5 years of the study (0.36±0.37 to 0.43±0.46 mm at year 5). One crown was recemented after 18 months in function and 1 crown was replaced because of a fracture to the porcelain incisal edge. Conclusion— The Astra Tech Implants ST were highly successful in single tooth replacement and bone levels during 5 years of function were stable. Resume Le but de cette etude a ete d'evaluer cliniquement et radiologiquement le systeme Astra Tech Implant ST pour le remplacement d'une dent, apres cinq annees en fonction. Quinze patients de seize a 48 ans avec une dent anterosuperieure manquante (six incisives centrales, huit laterales et une premolaire) ont ete implantes avec quatre implants de 13 mm et onze de 15 mm. Tous les patients ont ete revus a des intervalles de quatre a six mois pour l'entretien de l'hygiene buccale. Des radiographies periapicales utilisant la methode de Rinn avec long cone ont ete prises lors de l'insertion de la couronne et apres une, trois et cinq annees. Aucune perte implantaire n'a ete observee pour quatorze parmi les quinze patients. Aucune vis de l'implant ne s'est devissee et aucun probleme de tissus mous n'a ete observe. Lors du placement de la couronne, le niveau osseux moyen etait de 0.46±0.55 a 0.48 ±0.56 mm apicalement par rapport au sommet du col de l'implant. Il n'y avait aucune variation statistiquement significative pour les niveaux osseux radiographiques durant les cinq ans a la fin desquels ces mesures etaient respectivement de 0.36±0.37 a 0.43 ±0.46 mm. Une couronne a ete rescellee apres 18 mois. Une autre a ete remplacee suite a une fracture du bord incisif en porcelaine. Le systeme implantaire Astra Tech ST s'est revele excellent pour le remplacement unitaire, les niveaux osseux durant les cinq annees de fonction sont restes stables. Zusammenfassung Ziel: Das Astra Tech Implantat ST (Molndal Sweden) uber einen Zeitraum von 5 Jahren in Funktion klinisch und radiologisch zu untersuchen. Material und Methode. 15 Patienten (Alter zwischen 16 und 48) mit fehlenden Zahnen in der Oberkieferfront (6 zentrale Inzisiven, 8 laterale Inzisiven, 1 Pramolar) wurden vier 13 mm und elf 15 mm lange Einzelimplantate eingesetzt. Alle Patienten wurden alle 4 bis 6 Monate nachkontrolliert und die Mundhygiene uberwacht. Nach dem Einsetzen der Kronen und 1 Jahr, 3 und 5 Jahre nach dem Einsetzen der Kronen wurden periapikale Rontgenaufnahmen mit dem Filmhaltern des Rinnsystems und der Langtubustecknik aufgenommen. Resultate: Bei den 14 von insgesamt 15 Patienten, welche nachuntersucht werden konnten, war kein Implantatverlust zu verzeichnen. Es konnten keine lockeren Schrauben bei den Prothetikaufbauten und keine Probleme an den Weichgeweben beobachtet werden. Beim Einsetzen der Kronen lag das Knochenniveau 0.46±0.55 bis 0.48±0.56 mm apikal vom Oberteil des Implantathalses und es fanden wahrend der 5 Jahre dauernden Beobachtungszeit keine statistisch signifikanten Veranderungen im radiologischen Knochenniveau statt (0.36±0.37 bis 0.43±0.46 mm nach 5 Jahren). Eine Krone musste nach 18 Monaten in Funktion rezementiert und eine Krone wegen einer Porzellanfraktur der Inzisalkante ersetzt werden. Schlussfolgerung: Die Astra Tech Implantate ST waren fur den Einzelzahnersatz sehr erfolgreich und die Knochenniveaus waren wahrend der Beobachtungszeit von 5 Jahren in Funktion stabil. Resumen Intencion— Evaluar clinica y radiograficamente el implante Astra Tech ST (Molndal Suecia) para sustitucion de diente unico tras 5 anos en function. Sujetos y metodo− 15 pacientes (rango de edad de 16 a 48) con ausencia de dientes maxilares anteriores (6 incisivos centrales, 8 laterales, 1 bicuspide) recibieron cuatro implantes unitarios de 13 mm y once de 15 mm. Todos los pacientes fueron vistos con intervalos de 4 a 6 meses para mantenimiento de higiene oral. Se tomaron radiografias periapicales usando soportes Rinn y tecnica de cono largo en el momento de insercion de la corona y al ano, 3 y 5 anos. Resultados— No se observaron perdidas de implantes en 14 de los 15 pacientes disponibles para la evaluacion. No se observaron movilidades en los pilares o problemas de los tejidos blandos. En el momento de insertion de la corona el nivel medio de hueso fue de 0.46±0.55 a 0.48±0.56 mm apical de la parte alta del cuello del implante y no hubo cambios estadisticamente significativos en el nivel radiografico de hueso a lo largo de los 5 anos del estudio (0.36±0.37 a 0.43±0.46 mm en el quinto ano). Una corona se recemento despues de 18 meses en funcion y una corona se sustituyo por fractura de la porcelana en el borde incisai. Conclusion— Los implantes Astra Tech ST fueron altamente exitosos en la sustitucion de dientes unitarios y los niveles de hueso a los 5 anos se mantuvieron estables.

This case report describes the treatment of an adolescent girl with a skeletal Class II Division 2 malocclusion and impinging overbite. One of 2 previously extracted premolars had to be replaced by a single-tooth implant after adequate space reopening. An optimal overbite-overjet relationship was achieved through significant intrusion and proclination of maxillary and mandibular incisors. A horizontally impacted mandibular second molar was repositioned to ensure a 2-molar arch integrity. Resolution of the gingival smile line and favorable facial changes were also obtained. (Am J Orthod Dentofacial Orthop 2001;119:135-42)

An adult Class I malocclusion with a unilateral cleft lip and palate is presented. The maxillary transverse deficiency was managed with orthopedic expansion and the missing lateral incisor with space opening, bone grafting, and single tooth implant. The mild maxillary retrognathia and deficient lip support was managed with dental compensation.

Objective To evaluate the clinical effectiveness, common complications and maintenance associated with hydroxylapatite (HA) coated cylindrical implants when used to support single crowns. Design A prospective medium term clinical study of the Calcitek HA-coated implant. Setting Implant placement, crown fabrication and follow-up procedures were carried out at the Leeds Dental Institute, between 1990 and 1998. Subjects and method 26 patients (33 implants) participated in the trial. They were referred from general dental practitioners because of their suitability for single tooth implant placement. Main outcome measures The implants were assessed using recognised clinical review procedures eg radiographs and soft tissue assessments. Results At exposure there was 100% implant integration. The cumulative survival rate over 4 years was 100%. In five implants there was cervical bone loss of more than 4 mm and these were classified as failing. This gave an overall cumulative success rate of 58% by year 4. Conclusion The Calcitek HA-coated single tooth implant shows exceptionally high initial integration however, the longer term results suggest that the cervical bone level adjacent to the implant failed to establish a steady state. Doubts remain regarding the long-term prognosis of these cylindrical HA-coated implants.

The successful results of endosseous root form implants in the treatment of partially and completely edentulous patients has been made possible by the application of standardized surgical and prosthetic protocols. Different techniques have been published in the literature with the purpose of reducing implant prosthetic rehabilitation times. This clinical case report describes a new surgical concept and a technique to fabricate screw-retained provisional crowns for immediate loading of free-standing single tooth implants. Further clinical and histologic studies are necessary in order to promote routine clinical application of this technique.

Objectives: The degree of osseointegration and its patterns are important for the success of implants. 3D-FEA was used to determine interfacial stresses on a single tooth implant (IMZ) for four degrees of osseointegration (100, 75, 50 and 25%), and five patterns at 50% osseointegration (locally alternating, coronal only, apical only, facial only and lingual only). Methods: The implant was restored with a metal-ceramic crown and subjected to 10 MPa axial or oblique applied stress. Resolved stresses were examined at four heights along the implant-bone interface. Results: The degree of osseointegration did not affect resolved stress levels or distributions. Oblique loads elevated interfacial stresses 5 to 20 times. Stresses were always higher at the bone crest. Conclusions: Osseointegration patterns with crestal bone reduced both crestal and apical stresses. Apical only osseointegration produced much higher apical stresses. Crestal osseointegration and axial loads minimized overall stress.

The natural look of dental restorations has become a universally claimed treatment objective, especially when single-tooth gaps are restored with implants. A harmonious gingival margin is crucial to achieve this goal. This article presents a new procedure for exposure of single-tooth implants that yields a favorable esthetic result in the visible maxillary regions because of the simple type of incision used. The procedure consists of two incisions: the first incision makes it possible to find out the implant position and the second incision shapes the mucous membrane according to local supply. The second incision also prevents the soft tissue from tearing after careful stretching and subsequent pressing of the supraimplant mucosa. There is minimal soft tissue traumatization, and as a result, healing time can be reduced to 1 week and an appealing esthetic result can be reached.

Rapid, accurate seating of screw-retained implant abutment heads, where timing is controlled by internal or external hex designs, can be readily accomplished with individual, custom-cast abutment head location devices. The devices are especially useful when the abutment head-implant body complex is to be permanently cemented. The use and design of abutment seating jigs for single tooth implants and completely implant or implant and natural tooth-supported prostheses are described.

Initial root canal therapy and implant placement are both common treatment modalities, and, as such, prognostic factors that influence the treatment outcomes of these two restorations should be identified. In a retrospective chart review, 196 implant restorations and 196 matched initial nonsurgical root canal treated (NSRCT) teeth in patients were evaluated for four possible outcomes-success, survival, survival with intervention, and failure. Results showed that smokers had fewer successes and more failures in both groups (p = 0.0001), whereas NSRCT outcomes were affected by periradicular periodontitis (p = 0.001), post placement (p = 0.013), and overfilling (p = 0.003). Outcomes for both groups were not significantly affected by diabetes, age, or gender. Implant group outcomes were not affected by implant length (from 10 to 16 mm), diameter (from 3.25 to 5.5 mm), or an adjacent endodontically treated tooth, nor were NSRCT outcomes affected by the number of appointments for the procedure.

Congenitally missing teeth are frequently presented to the dentist. Interdisciplinary approach may be needed for the proper treatment plan. The available treatment modalities to replace congenitally missing teeth include prosthodontic fixed and removable prostheses, resin bonded retainers, orthodontic movement of maxillary canine to the lateral incisor site and single tooth implants. Dental implants offer a promising treatment option for placement of congenitally missing teeth. Interdisciplinary approach may be needed in these cases. This article aims to present a case report of replacement of bilaterally congenitally missing maxillary lateral incisors and right mandibular second premolar with dental implants.

The anterior single-tooth implant presents many restorative challenges. Several abutments have been developed in pursuit of anesthetic and functional solution. This article describes a technique for a custom abutment. This abutment is copy-milled from titanium in an anatomic form with a countertorque device and provides the flexibility to create an esthetic restoration for the anterior single-tooth implant.

A common problem associated with single tooth implant restorations is abutment screw loosening. Manufacturers of implants have attempted to overcome this problem by incorporating antirotational design characteristics into their systems. Micromovement and torque levels required to loosen abutment screws for straight and angled antirotational screw-retained abutment/implant combinations from three different manufacturers were examined in this in vitro investigation. A custom-built machine was used and each sample was subjected to compressive horizontal reciprocal movements over a 25-degree incline for a simulated 1-month period. Data were generated that showed movements of the crown/abutment complex during force application. The amount of torque necessary to loosen the abutment screws before and after testing was also recorded and compared for each system. The results indicated no significant differences (p0.05) among all the straight and angled abutments for the variables studied.

Despite the increased demands for single tooth implants, many patients still opt for fixed partial dentures to close the edentulous spaces . Prior to the replacement of missing teeth, aesthetic and physiologic corrections of edentulous areas are critical pre-requisites. This case describes a simple method to enhance a localized buccal ridge defect and create an emergence profile in relation to the maxillary right premolar region, prior to the construction of a fixed partial denture. This technique involved using a connective tissue and platelet rich fibrin membrane for soft tissue augmentation, so as to obtain a natural form and maintain a healthy periodontium. Clinical Relevance to Interdisciplinary Dentistry Role of pre-prosthetic periodontal surgery to achieve improved aesthetics. Use of Connective tissue graft and PRF for a more predictable outcome. This simple technique enabled the simultaneous preparation and augmentation of the ridge.

Background: Immediate single-tooth implant has become an increasingly common and successful treatment. Single-tooth rehabilitation patients can be predictably treated with a favorable esthetic outcome using immediate provisionalization. Use of removable prosthesis soon after the extraction of anterior tooth has been replaced by single-tooth implants with immediate provisionalization. The goal of this study is to evaluate the long-term survival rate of single-tooth implants in fresh extracted sites at the maxillary and mandibular anterior region, followed by immediate provisionalization. Materials and Methods: A total of 42 implants were placed in 29 patients. Immediate provisionalization restorations were placed. Occlusal contacts were avoided. Follow-up started from the day of implantation, and ranged from 24 to 48 months, with an average of 36 months. Results: Two implants failed 1 month after placement due to bone loss and overloading, leading to peri-implantitis. Overall survival rate was 95%. The mean marginal bone loss was 1.5±2 mm. Conclusion: The greatest benefit from this procedure is patient's satisfaction. Immediate provisionalization of single-tooth implants at fresh extracted sites is effective, when minimal provisionalization criteria are met.

Today, implants are considered as a first treatment option to replace missing teeth due to the considerable advantages over the other available options. The ultimate goal of implant treatment is to restore natural esthetics, function, long term health, and patient comfort. Hence, case selection and treatment planning are very crucial to achieve longevity and predictability of the restoration. This article presents a step-by-step protocol for gathering and analyzing the various factors at the pretreatment evaluation stage to set the groundwork for a dentist to consider implant as a restorative option. Clinical Relevance to Interdisciplinary Dentistry To help the restorative dentist to identify the ideal implant receptor site. Sound periodontal and restorative status is prerequisite to consider implant treatment as an option. Restorative driven implant placement is paramount for overall integrity of the dentition.

Purpose: The aim of this study is to assess the influence exerted by the observer’s dental specialization and compare patients’ opinion with observers’ opinion of the esthetics of maxillary single-tooth implants in the esthetic zone. Methods: Forty-one adult patients, who were treated with a single implant in the esthetic zone, were enrolled in this study. Eight observers (2 periodontists, 2 prosthodontists, 2 orthodontists and 2 senior dental students) applied the pink esthetic score (PES)/white esthetic score (WES) to 41 implant-supported single restorations twice with an interval of 4 weeks. We used a visual analog scale (VAS) to assess the patient’s satisfaction with the treatment outcome from an esthetic point of view. Results: In the PES/WES, very good and moderate intraobserver agreements were noted between the first and second rating. The mean total PES/WES was 11.19 ± 3.59. The mean PES was 5.17 ± 2.29 and mean WES was 6.02 ± 1.96. In the total PES/WES, the difference between the groups was not significant. However, in the WES, the difference between the groups was significant and prosthodontists were found to have assigned poorer ratings than the other groups. Periodontists gave higher ratings than prosthodontists and senior dental students. Orthodontists were clearly more critical than the other observers. The statistical analysis revealed statistically significant correlation between patients’ esthetic perception and dentists’ perception of the anterior tooth. However, the correlation between the total PES/WES and the VAS score for the first premolar was not statistically significant. Conclusions: The PES/WES is an objective tool in rating the esthetics of implant supported single crowns and adjacent soft tissues. Orthodontists were the most critical observers, while periodontists were more generous than other observers. The statistical analysis revealed a statistically significant correlation between patients’ esthetic perception and dentists’ perception of the anterior tooth.

For the successful outcome of implant rehabilitation, a functional prosthesis is as significant as an uneventful surgery. A variety of abutment designs are available for the restoration of a single tooth implant. These variations are an outcome of the requirement for the better orientation of the implant to the occlusal plane and to adjust the abutment according to the given implant position and angulation. Varied clinical situations may preclude traditional abutments and require special or customized abutments. Moreover, there is a requirement to develop an alternative to resolve the frequent problem of screw loosening observed in the screw-retained abutments. This paper discusses a new and easy approach for the fabrication of a cemented custom-made cast post-and-core abutment to be used with all types of implant systems.

Purpose This study evaluated the status of teeth adjacent to single-tooth implants in the anterior and posterior jaw during a follow-up of more than 3 years. Materials and methods Seventy-eight single-tooth implants and 148 adjacent teeth were followed for a mean of 58 months. Implant survival rate, peri-implant structures, and prosthetic complication rates were evaluated. Crowns and periodontal status of adjacent teeth were compared at crown placement and at the last examination. Horizontal distance from the implant edge to adjacent teeth was calculated and compared for anterior and posterior regions. The influence of approximal crestal bone resorption of the adjacent teeth was calculated using multivariate regression analysis. Results The clinical findings for implants (one loss), peri-implant structures, and prosthetic complication rates (three crown fractures) were excellent. There was a high proportion of intact adjacent teeth in both anterior and posterior regions at crown placement and at the follow-up examination. No adjacent teeth required extraction or endodontic treatment, and only four required restoration. Comparison of the periodontal status at crown placement and at follow-up revealed no differences for plaque and bleeding indices or for pocket depth of adjacent teeth. There was a significant influence of the horizontal distance on approximal bone loss in the closer distance of the anterior region, but not in the posterior region. Conclusion The crown and periodontal status of teeth adjacent to single-implant restorations was excellent. The approximal bone crest reduction of the adjacent teeth was significantly influenced by the horizontal distance between the implant edge and neighboring tooth.

Objective: To systematically review clinical studies on the performance of implant-supported single-tooth restorations (STR). Data sources: Medline 1990–1998, using keywords, ‘dental in SB’, ‘implant’ and ‘single’. Study selection: Only English papers that met a strict three-level selection procedure, including availability of or the ability to calculate life-table survival curves, were included. Data extraction and synthesis Cumulative life-table survival curves were constructed by pooling data from the included studies to new data sets. Results: Of 332 papers initially identified, the majority were excluded because they were case reports, technical notes or descriptions of clinical procedures. Nine studies met all the criteria with the data predicting a 97%(±1%) survival implant survival at 4 years, with an uncomplicated crown survival rate of 83%(±3%). Conclusions: Single tooth implants have an acceptable short-term survival rate. More information and better quality clinical studies and reporting are needed, however. Creugers NHJ, Kreulen CM, Snoek PA, deKanter RJAM. A systematic review of single-tooth restorations supported by implants. J. Dent 2000; 28:209–217

Objective To evaluate the clinical effectiveness, common complications and maintenance associated with hydroxylapatite (HA) coated cylindrical implants when used to support single crowns. Design A prospective medium term clinical study of the Calcitek HA-coated implant. Setting Implant placement, crown fabrication and follow-up procedures were carried out at the Leeds Dental Institute, between 1990 and 1998. Subjects and method 26 patients (33 implants) participated in the trial. They were referred from general dental practitioners because of their suitability for single tooth implant placement. Main outcome measures The implants were assessed using recognised clinical review procedures eg radiographs and soft tissue assessments. Results At exposure there was 100% implant integration. The cumulative survival rate over 4 years was 100%. In five implants there was cervical bone loss of more than 4 mm and these were classified as failing. This gave an overall cumulative success rate of 58% by year 4. Conclusion The Calcitek HA-coated single tooth implant shows exceptionally high initial integration. However, the longer term results suggest that the cervical bone level adjacent to the implant failed to establish a steady state. Doubts remain regarding the long-term prognosis of these cylindrical HA-coated implants.

Placing an anterior single-tooth implant requires thorough planning, informed abutment selection and precise surgical technique. Planning procedures are outlined; abutments, including UCLA's non-segmented, Nobelpharma's single-tooth, CeraOne and non-rotational, implant innovations' pre-angled and non-rotational and DIA's anatomic, are described, with indications and contraindications; and placement considerations are discussed.

Five different implant materials and three different geometries of ankylosed single-tooth implants were investigated. The stress distributions within and around the implants were determined by finite element analysis. Results show that the optimal combination of implant material and geometry can reduce implant and alveolar stresses by a factor of three when compared to an arbitrary implant design.

This study delineates the effects of varying the root length as well as incorporating a soft pseudo periodontal ligament on the overall stress distribution for each of five different implant materials and one implant design.

ResumenPropósitoEl presente artículo es un estudio prospectivo de las tasas de éxito implantaria y de las complicaciones mecánicas y biológicas en el tratamiento rehabilitador implanto-asistido del sector posterior de la maxila, mediante provisionalización inmediata.Material y MétodoEl estudio clínico observó a 21 sujetos desdentados parciales unitarios del sector posterior maxilar, con reborde cicatrizado y antagonista dentario natural, por un período de 6 meses, en los que se insertaron implantes cónicos roscados de conexión interna, con tratamiento de superficie, temporizados inmediatamente después de insertados en el hueso maxilar, mediante la confección de una corona de resina acrílica sobre un pilar temporal de titanio atornillada directa al implante, dejados sin contactos dentarios durante la máxima intercuspidación (MIC) y movimientos excéntricos mandibulares. Todas las restauraciones fueron observadas durante un período de 6 meses, evaluando tasa de éxito implantario, complicaciones biológicas y mecánicas.ResultadosSe insertaron 25 implantes en 21 pacientes, obteniéndose un valor promedio de inserción de torque quirúrgico de 45.6 Nt. Durante el período de observación clínico se presentó un 100% de éxito de sobrevida implantario, no se detectaron complicaciones biológicas, pero sí se presentaron complicaciones mecánicas por fractura de una cúspide vestibular de una restauración provisional acrílica y dos aflojamientos de tornillos.ConclusionesLa temporización unitaria mediante provisorio atornillado es un protocolo predecible y confiable que permite el proceso de oseointegración y la coexistencia en salud de tejido periimplantario y su sistema protésico.AbstractPurposeThis article is a prospective study of implant success rates and of mechanical and biological complications in the assisted-implant rehabilitation treatment of the posterior maxilla by immediate temporization.Material and MethodsThe clinical study observed 21 partially edentulous subjects with lip scar and antagonistic natural teeth in the posterior maxilla for a period of 6 months in which conical threaded internal implant connections were inserted with a surface treatment and timed immediately after being inserted into the jawbone by producing an acrylic resin crown on a temporary titanium abutment screwed directly into the implant and left without tooth contacts during the Maximal Intercuspal (MIC) and mandibular eccentric movements. All restorations were observed over a period of 6 months evaluating implant success rate and biological and mechanical complications.Results25 implants were inserted into 21 patients yielding an average surgical insertion torque of 45.6 Nt. During the clinical observation there was 100% success of implant survival. No biological complications were detected, but there were mechanical complications - a buccal cusp fracture of an acrylic provisional restoration and two screws loosening.ConclusionsThe unit temporization by temporary screwing is a predictable and reliable protocol that allows osseointegration and the coexistence in the health of peri-implant tissue and its prosthetic system.

Because of the proliferation of implant systems, a set of criteria for implant success based on scientific investigations is essential. A review of the literature and the analysis of the results indicate that six criteria are supported as valid for determining the clinical success of endosseous dental implants. These criteria are proposed for use in clinical investigation on implants.