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The term "buccal implant position" is commonly used but lacks a precise definition and missing a reference point. Considering its major impact on peri-implantitis and esthetic failures the purpose of this study was to find a correlation between bucco-palatal implant positioning and the midfacial soft tissue level of implant crowns using newly defined Emergence-points.Patients with unilateral single-tooth implant crowns in the region of the central or lateral maxillary incisor were included in this study. Digital intraoral scans were superimposed over a scan of the master cast or the original digital data set and analyzed in a computer planning program. In relation to the corresponding natural tooth, an ideal Emergence-point (ESeventy-three patients met the inclusion criteria. AD ranged from 0 to 3.5 mm (AD = 0.87 ± 1.01), SIP from 0.2 to 5.1 mm (AD = 2.66 ± 1.64). Statistical analysis showed a significant inverse correlation between AD and SIP (ρ = -.55, p .001). VIP, the implant inclination, time span since implant insertion, and phenotype revealed no significant correlation to AD.The more palatal the implant was positioned, the less AD was observed. The position of the implant shoulder should preferably be planned more than 2 mm behind the ideal E-point. This E-point can be used for implant planning as it defines the ideal crown length for prospective planning.

Background Due to chronic inflammation or trauma facial bone is frequently missing after tooth loss in the esthetic zone. As a consequence, procedures to augment or at least to preserve bone are frequently necessary prior to implant placement. Purpose The aim of this retrospective case series is to demonstrate the applicability of a staged all-flapless concept to establish satisfactory implant restorations following situations of partial missing facial bone in the esthetic zone. Materials and methods Radiological/clinical data of 25 patients were analyzed and an esthetic evaluation of 24 patients was performed. The staged concept included ridge preservation at time of tooth extraction and delayed guided implant placement. Marginal bone loss was measured radiologically and esthetic evaluation was performed based on standardized photographs using the Pink Esthetic Score as well as the Papilla Index. Results Implant success rate revealed 100%. The mean radiological peri-implant marginal bone loss measured 1.16 mm (SD: 0.16). Regarding the esthetic outcome 71% of patients were evaluated with a Pink Esthetic Score higher or equal to 10 constituting satisfactory esthetics (median pink esthetic score: 10). The mean follow-up time for clinical and radiographic analysis was 1.3 years (SD: 0.6 years) and 1.2 years (SD: 0.6) for esthetic evaluation. Conclusion Although marginal bone loss cannot be avoided, the staged concept of flapless ridge preservation and subsequent delayed flapless guided implant placement carries the potential to improve esthetics of single-tooth implants in the anterior maxilla.

Losing teeth – particularly in the aesthetic zone of the anterior maxilla – represents a great dilemma for a patient and a challenge for the attending dentist. Immediate placement of dental implants at the day of tooth extraction is an established treatment concept that offers the possibility to provide fixed provisional crowns within few hours. Troublesome removable prostheses can thus be avoided, and the psychological trauma of tooth loss is minimised. The Copy-abutment technique was developed at the Academy for Oral Implantology in Vienna (Austria) and guarantees the best possible preservation of soft-tissue aesthetics by immediate implant restoration using custom-made abutments composed of highly aesthetic zirconia ceramic. On the basis of a modern all-digital workflow and a close cooperation with the affiliated dental laboratory, it is possible to provide the patient with a new tooth in just 1 day.

Purpose: To compare long-term survival and marginal bone loss of immediate interantral implants in the nonaugmented maxilla subjected to immediate vs delayed loading. Materials and Methods: Graftless maxillary cross-arch rehabilitation was performed in a total of 362 patients in the years 2004 to 2013 (1,797 implants). Of the 240 patients with immediate implants replacing their failing maxillary dentition, 81% were subjected to immediate loading and 19% to delayed loading of their 4 to 6 interantral implants (980 and 235 implants, respectively). Kaplan-Meier survival estimates were computed and marginal bone loss was evaluated in a stratified random sample of 20 patients per group. Results: Thirty-one of 1,215 implants failed within the mean observation period of 3.9 years, and no difference in 8-year survival estimates could be seen between immediate (97.6% [95% CI: 96.7 to 98.6]) and delayed (96.6% [95% CI: 94.3 to 98.9]) loading protocols (P = .359). Mean marginal bone resorption following implant insertion did not differ significantly between the groups (1.5 ± 1.7 mm vs 0.7 ± 1.1 mm, P = .379); however, it was significantly associated with a reduced number of implants (P = .017) and patient history of periodontal disease (P < .001). Conclusion: Immediate loading of interantral implants yields satisfactory results in the transition of patients from a failing maxillary dentition to full-arch implant rehabilitation and thus may be favored over delayed loading concepts.

Background Implant esthetics may benefit from individualized zirconia abutments copying the emergence profile of the natural tooth and delivered within days after immediate implant insertion. Purpose To investigate the esthetic outcome of the Copy-Abutment technique using the Pink Esthetic Score (PES). Materials and Methods A total of 77 patients with single-tooth implants in the anterior maxilla restored at the day of immediate implant placement using Copy-Abutments and provisional crowns were followed-up after 1 week, 1 month, 4 months, 6 months, 1, 2, 3, 4, and 5 years to assess implant esthetics. Results PES ranged between 7 and 14 (median: 13) and improved significantly between the 6 month and 1 year follow-up (p

Purpose: Failing residual dentition gives rise to patient concerns about the surgical and prosthodontic management of immediate implant rehabilitation. The purpose of this study was to assess subjective patient experiences of full-arch immediate implant loading. Materials and Methods: Patients made a transition from poor dentition in the maxilla (25 patients) or mandible (25 patients) to full-arch rehabilitation on the day of extraction using four interantral or interforaminal implants. Provisional restoration was performed, and postoperative pain, swelling, and patient-perceived impairment in the first week was recorded. Results: Absence of pain was reported by 40%, 52%, and 66% of patients, on the day of surgery, on the first day after surgery, and on the second day after surgery, respectively; pain levels decreased significantly (from 1.8 to 0.9, P < .001) and patient-reported swelling decreased from 1.5 to 1.3 (P = .058) on a 10-point scale. Postoperative impairment of everyday life and work (mean score = 1.1) was significantly less pronounced than impairment of food intake (mean score = 2.2; P = .004) or speech (mean score = 1.9; P = .002). Of these patients, 88% would again undergo the procedure without doubt. Conclusion: Although patient-perceived morbidity after immediate full-arch implant rehabilitation is low in general, minor masticatory and phonetic impairment should be taken into account.

Bone grafting of the maxillary sinus is attempted to compensate for sinus pneumatization and permit reliable insertion of endosseous dental implants for prosthetic rehabilitation. The aim of the present clinical investigation was to study bone regeneration four months after transcrestal sinus floor elevation via the Gel-Pressure Technique (GPT) and application of pasteous nano-crystalline hydroxyapatite bone substitute. A total of 25 patients with deficient alveolar ridges in the posterior maxilla (mean residual bone height: 4.7 ± 1.8 mm) were subjected to 32 flapless transcrestal sinus floor augmentations and simultaneous insertion of 40 implants. Sinus membrane elevation height averaged 11.2 ± 2.7 mm and minimal vertical graft resorption of 0.1 mm was observed after four months. Radiographic bone density averaged 460 Hounsfield units in regions adjacent to the native jawbone (1 to 7 mm distance), while reduction of bone density by −7.2%, −11.3%, −14.8%, −19.6% and −22.7% was recorded in more apical regions of 8, 9, 10, 11, and ≥12 mm distance to the original sinus floor, respectively. The results suggest that graft remodeling is completed up to a distance of 7 mm within a healing period of four months after sinus augmentation using nano-crystalline hydroxyapatite bone substitute material.

Background Flapless implant placement using surgical templates may guarantee predictable and esthetic results provided that preplanned implant positions are transfered precisely into surgical reality. Purpose The study aims to investigate the effect of three-dimensional accuracy in guided implant surgery on the esthetic outcome of single-tooth implants in the anterior maxilla. Materials and Methods Single-tooth implants for delayed replacement of upper incisors were inserted in 27 patients using stereolithographic templates. Superimposition of postoperative cone beam computed tomography (CBCT) scans allowed assessment of positional inaccuracy at the implant shoulder and apex, as well as angular deviation. Objective evaluation of implant esthetics was performed after a mean follow-up of 2.3 years using the Pink Esthetic Score (PES). Results Mean deviation between planned and actual implant position was 0.84 mm at the implant shoulder and significantly correlated to average PES of 12 (p = .031). Inaccuracy toward the buccal side was most frequent (70%). Deviations ≥ 0.8 mm resulted in significantly worse implant esthetics (median PES: 9.5, interquartile range [IQR]: 8–11) compared with more accurate implant positions (median PES: 13, IQR: 12–13, p = .039). Conclusion Positional inaccuracy is low in guided implant surgery, but may however significantly compromise implant esthetics in the anterior maxilla.

Periimplantitis is the most frequent cause of late implant failure; however, little is known about the long-term success of periimplantitis treatment and the effectiveness of various therapeutic interventions.A total of 142 patients were referred to the Academy for Oral Implantology in Vienna for the treatment of recurrent periimplantitis around single-tooth implants. Of them, 72 patients (51%) were treated by laser decontamination, 47 patients (33%) by implantoplasty surgery, and 23 patients (16%) by a combination of both approaches.Overall success of periimplantitis therapy was 89% after 9 years of follow-up, and it did not differ significantly between female and male patients (P = 0.426). The number of implant failures that could not be prevented by periimplantitis treatment was 6 after laser decontamination (8%), 6 after implantoplasty surgery (13%), and 4 after a combination of both therapies (17%). Implant loss occurred after 4.9 ± 1.9 years of therapy, on average. No significant difference between the 3 treatment groups could be observed (P = 0.393).The present results suggest that success rates of periimplantitis therapy with either laser decontamination or surgical implantoplasty are high. These success rates do not appear to be associated with patient gender or treatment strategy.

Purpose: To compare long-term survival and marginal bone loss of late interantral implants in the nonaugmented edentulous maxilla subjected to immediate vs delayed loading. Materials and Methods: One hundred twenty-two edentulous patients with implants in native, healed jawbone were subjected to either immediate loading (179 implants) or delayed loading (403 implants) of their four to six interantral implants (part I of 362 graftless maxillary cross-arch rehabilitations performed in the years 2004 to 2013). Kaplan-Meier survival estimates were computed, and marginal bone loss was evaluated in a stratified random sample of 20 patients per group. Results: Fifteen of 582 implants failed within the mean observation period of 4.7 years, and no difference in 8-year survival estimates could be seen between immediate (98.3% [95% CI: 96.4-100.0]) and delayed (96.7% [95% CI: 94.7-98.6]) loading protocols (P = .370). Mean marginal bone resorption following implant insertion did not differ significantly between the groups (1.1 ± 1.3 mm vs 1.4 ± 1.3 mm, P = .490). Conclusion: Immediate loading of interantral implants in the nonaugmented edentulous maxilla yields favorable results comparable to delayed loading and may be considered to shorten periods of removable provisional prostheses in maxillary edentulism.

The aim of this study was to compare selected crevicular markers in early wound healing after second stage surgery and immediately restored implant placement. A total of ten patients (mean age 53 years, 6 females and 4 males) to be treated with all together 20 single tooth implants were enrolled in the study. In 9 cases a second stage surgery after conventional submerged implant healing was performed, in the remaining 11 cases immediate implants were planned prior to tooth extraction. Beginning 1 day after implant installation and provisional restoration according to the copy abutment technique and 1 day after healing abutment insertion, respectively, peri-implant crevicular fluid samples (PICF) were collected, the PICF flow rate was recorded and laboratory assays performed for the assessment of interleukin-1β (IL-1β) and neutrophil elastase (NPE) concentrations (T1). Follow-up intervals were scheduled 1–3 weeks postoperatively (T2–4). Statistical analyses included explorative data analysis and median statistics (Wilcoxon test). Wound healing was uneventful in all cases and the concentrations of IL-1β and NPE remained stable over the entire observation period. Standard deviations and medians for IL-1β were higher in the second stage implant group with statistically significant differences in the concentrations on T2 and T4. No differences were found for NPE. The small sample size of this pilot investigation requires careful interpretation of the data presented. Within the limitations of this study it may be concluded that both immediately placed implants and implants at second stage surgery show similar patterns of wound healing with regard to selected markers of peri-implant disease, with minor differences in IL-1β concentrations on follow-up in favor of immediate implantation and restoration.

Implant esthetics may benefit from individualized zirconia abutments copying the emergence profile of the natural tooth and delivered within days after immediate implant insertion.To investigate the esthetic outcome of the Copy-Abutment technique using the Pink Esthetic Score (PES).A total of 77 patients with single-tooth implants in the anterior maxilla restored at the day of immediate implant placement using Copy-Abutments and provisional crowns were followed-up after 1 week, 1 month, 4 months, 6 months, 1, 2, 3, 4, and 5 years to assess implant esthetics.PES ranged between 7 and 14 (median: 13) and improved significantly between the 6 month and 1 year follow-up (p .001), then remained stable up to the fifth year. Significant improvement was seen for the variables PES-6 soft tissue color (p = .002) and PES-7 soft tissue texture (p .001) up to the 1 year follow-up, while PES-5 alveolar process deficiency deteriorated (p = .016). Mean mucosal recession was 0.26 ± 0.86 mm (range: 0-1.6) after 5 years and not related to gingival biotype.Copy-Abutments for immediate restoration of implants in the esthetic zone show satisfactory long-term esthetic outcomes.

Minimally invasive implantology using reduced implant dimensions as well as virtual treatment planning and CAD/CAM stereolithographic templates has gained popularity in recent years. The aim of the present investigation was to analyze prevailing trends in clinical utilization of these graftless therapeutic options.A total of 12.865 dental implants were placed in 5.365 patients at the Academy for Oral Implantology in Vienna, of which 5.5% were short (length 10 mm), 19.5% narrow (diameter 3.75 mm) and 10.6% template-guided. Application trends were analyzed using linear regression and compared between jaw location and dentition subgroups.Use of short implants and guided surgery increased significantly in all subgroups. Narrow-diameter implants were most frequent in single-tooth gaps (24.1%), however, upward trends could only be observed in partially and completely edentulous patients. Short implants were predominantly used in the mandible (9.9% vs. 2.5%, P 0.001) while guided surgery was favored in the maxilla (14.2% vs. 5.4%, P 0.001).Short implants (most frequent in partial edentulism) and guided implant surgery (most frequent in complete edentulism) represent uprising and promising surgical approaches to avoid patient morbidity associated with bone graft surgery.

Prosthodontically driven biomechanical considerations are essential for longterm successful outcomes in dental implant therapy. Correct protocols seek to preclude potential consequences associated with functional and parafunctional occlusal overload such as screw loosening, component fracture, compromised marginal bone maintenance, and the integrity of the induced osseointegration response. Other concerns also need to be addressed, more especially when other implants are selected, for example: bridge insertion torque (BIT) in cases of immediate loading, cantilever length-anteroposterior spread ratio (CL-AP), overall crown-to-implant ratio (oCIR), total bone-to-implant surface area (tBICA), and the status of the opposing dentition. In spite of promising clinical results, evidence-based clinical protocols demand that such biomechanical limits still need to be determined.

Aim: In this study, the reproducibility of a newly developed pink esthetic score (PES) for evaluating soft tissue around single-tooth implant crowns was assessed. The effect of observer specialization was another point of interest. Material and methods: Twenty observers (five prosthodontists, five oral surgeons, five orthodontists and five dental students) were given photographs of 30 single-tooth implant crowns. Seven variables were evaluated vs. a natural reference tooth: mesial papilla, distal papilla, soft-tissue level, soft-tissue contour, alveolar process deficiency, soft-tissue color and texture. Using a 0-1-2 scoring system, 0 being the lowest, 2 being the highest value, the maximum achievable PES was 14. Each observer was requested to make two assessments at an interval of 4 weeks. At the second assessment, the photographs were scored in the reverse order. Results: The mean PES of evaluations at the first assessment (n=600) was 9.46 (±3.81 SD), and 9.24 (±3.8 SD) at the second one. The difference between these two means was not significant statistically (P=0.6379). Implant-related mean PES for single-tooth implants varied from 2.28 to 13.8, with standard deviations between 0.46 and 3.51. Very poor and very esthetic restorations showed the smallest standard deviations. The mean total PES was 10.6 for the prosthodontists, 9.2 for the oral surgeons, 9.9 for the dental students and 7.6 for the orthodontists. Conclusions: The PES reproducibly evaluates peri-implant soft tissue around single-tooth implants. Thus, an objective outcome of different surgical or prosthodontic protocols can be assessed. Orthodontists were clearly more critical than the other observers.

In a previous study (Haas et al. 1995), we reported on preliminary results of 76 Branemark implants placed in 71 patients with single-tooth gaps. The present study examines the results of the same group over a longer period of time: 55 implants were followed for more than 5 years, 12 for a period between 4 and 5 years and 1 implant for 46 months. One patient died 3 years after implant placement. Five patients lost their implant within 24 months after insertion. The drop-out rate was 2 implants in 2 patients. The recall rate was thus 97%. Of the 5 implant failures, 2 were located in the maxilla and 3 in the mandible. The Kaplan-Meier survival probability was 93% after 120 months. 74% of the sites showed healthy peri-implant soft tissue conditions. At 15 implants (22%) a bone resorption of more than 2 mm was observed on intraoral radiographs. The mean bone resorption was 1.8 mm in the maxilla and 1.3 mm in the mandible and did not increase with time (Pearson correlation coefficient: r = -0.06, P = 0.59). Abutment loosening occurred in 7 implants (10%), however all abutments that were fixed with a defined torque subsequently remained stable. Thus the favourable preliminary results could be maintained over an average 66 months, indicating that if implant loss happens it seems to occur during the first 2 years after insertion.

Flapless implant placement using surgical templates may guarantee predictable and esthetic results provided that preplanned implant positions are transfered precisely into surgical reality.The study aims to investigate the effect of three-dimensional accuracy in guided implant surgery on the esthetic outcome of single-tooth implants in the anterior maxilla.Single-tooth implants for delayed replacement of upper incisors were inserted in 27 patients using stereolithographic templates. Superimposition of postoperative cone beam computed tomography (CBCT) scans allowed assessment of positional inaccuracy at the implant shoulder and apex, as well as angular deviation. Objective evaluation of implant esthetics was performed after a mean follow-up of 2.3 years using the Pink Esthetic Score (PES).Mean deviation between planned and actual implant position was 0.84 mm at the implant shoulder and significantly correlated to average PES of 12 (p = .031). Inaccuracy toward the buccal side was most frequent (70%). Deviations ≥ 0.8 mm resulted in significantly worse implant esthetics (median PES: 9.5, interquartile range [IQR]: 8-11) compared with more accurate implant positions (median PES: 13, IQR: 12-13, p = .039).Positional inaccuracy is low in guided implant surgery, but may however significantly compromise implant esthetics in the anterior maxilla.

To evaluate patient satisfaction, oral health-related quality of life, and patients' preferences towards minimally invasive treatment options for graftless rehabilitation of complete edentulism by means of dental implants.A MEDLINE search of literature in the English language up to the year 2013 was performed to summarise current evidence from the patient's perspective. The final selection included 37 studies reporting on minimally invasive implant treatment of 648 edentulous maxillae and 791 edentulous mandibles in 1328 patients, via a total of 5766 implants.Patient satisfaction averaged 91% with flapless implant placement (range: 77 to 100%), 89% with short implants, 87% with narrow-diameter implants (range: 80 to 93%), 90% with a reduced number of implants (range: 77 to 100%), 94% with tilted implant placement (range: 58 to 100%), and 83% with zygomatic fixtures (range: 50 to 97%). Indirect comparison yielded patient preference towards tilted implant placement compared to a reduced number of implants (P = 0.036), as well as to zygomatic implants (P = 0.001).While little evidence on patients' preferences towards minimally invasive treatment alternatives vs. bone augmentation surgery could be identified from within-study comparison, it may be concluded that patient satisfaction with graftless solutions for implant rehabilitation of completely edentulous jaws is generally high. Comparative effectiveness research is needed to substantiate their positive appeal to potential implant patients and possible reduction of the indication span for invasive bone graft surgery.

The study investigated two mandibular positions based upon computerized axiography recordings of hinge axis movements of 262 subjects. Next to the well-known guided closure position RP (reference position by chin-point guidance), the position of final deglutition (FD) was quantified. FD represented the hinge axis position at the end of the swallowing movement. The results elicited average linear distances of 0.32 +/- 0.43 mm on the right and 0.33 +/- 0.40 mm on the left side between both positions in the sagittal plane. The average distance in the frontal plane was 0.02 mm (right) and 0.04 mm (left). Approximately 46 per cent of FD recordings were found anterior and inferior to RP, and showed significant difference to posterior and anterior-superior FD recordings. The replicability of both positions was tested on 53 subjects and averaged 0.04 mm (FD) and 0.09 mm (RP). Average deviations of repeated recordings within the subject ranged from 0.07 to 0.47 mm (FD) and 0.07 to 0.57 mm (RP) for each spatial direction. The results of this study showed a relative coincidence of an average FD and RP Variation of FD in anterior inferior direction questioned the clinical reliability of FD to reassure the guided closure position.

The aim of this study was to evaluate the sagittal inclination of interforaminal implants, the clinical implant outcome, and the necessary extent of prosthodontic compensation modalities for implant overdentures (IODs).Lateral cephalometric radiographs of 62 patients, each with a mandibular IOD retained by 2 to 4 implants, were analyzed. The sagittal inclination of the longitudinal implant axis of the most anterior implant was analyzed relative to the mandibular and occlusal planes. The angle needed to compensate for the inclination of the mandibular implant to obtain Angle's class I for the prosthesis (the compensation angle) was measured and compared with respect to skeletal class. Peri-implant structures were measured using the Plaque Index and the Gingival Index. The compensation angle was correlated with the mandibular implant inclination, the degree of mandibular atrophy, and the anterior facial height.The most anterior mandibular implants showed a mean retroinclination of 74.3 +/- 9.3 degrees in relation to the mandibular plane; retroinclination was significantly more pronounced in skeletal class II than skeletal classes I and III (P.05). The compensation angle (26.9 +/- 10.5 degrees) was more significant for skeletal class II than for skeletal classes I and III (P.01). Sagittal mandibular implant inclination correlated significantly to the compensation angle (r = -0.46; P.05), mandibular atrophy (r = 0.32; P.05) and mandibular facial height (r = -0.45; P.05). Implant survival rate and peri-implant parameters (bone loss, pocket-depth, Plaque and Gingival Indices) of the interforaminal implants were not shown to be influenced by implant retroinclination. Nine patients (2 skeletal class 1, 7 skeletal class II) reported phonetic problems with the IOD because of narrowing of the lingual space but described significant improvement after a median 4.7 months (range, 3 to 12 months).Depending on skeletal class, prosthetic compensatory mechanisms will be operative in the presence of mandibular implant retroinclination for IOD. Knowledge of mandibular inclinations and the compensatory mechanisms may be an essential factor in successful prosthetic rehabilitation and may provide for a homogenous design of the bar construction and easier handling and may also reduce stress on the attachment mechanism.

In this study, the reproducibility of a newly developed pink esthetic score (PES) for evaluating soft tissue around single-tooth implant crowns was assessed. The effect of observer specialization was another point of interest.Twenty observers (five prosthodontists, five oral surgeons, five orthodontists and five dental students) were given photographs of 30 single-tooth implant crowns. Seven variables were evaluated vs. a natural reference tooth: mesial papilla, distal papilla, soft-tissue level, soft-tissue contour, alveolar process deficiency, soft-tissue color and texture. Using a 0-1-2 scoring system, 0 being the lowest, 2 being the highest value, the maximum achievable PES was 14. Each observer was requested to make two assessments at an interval of 4 weeks. At the second assessment, the photographs were scored in the reverse order.The mean PES of evaluations at the first assessment (n=600) was 9.46 (+/-3.81 SD), and 9.24 (+/-3.8 SD) at the second one. The difference between these two means was not significant statistically (P=0.6379). Implant-related mean PES for single-tooth implants varied from 2.28 to 13.8, with standard deviations between 0.46 and 3.51. Very poor and very esthetic restorations showed the smallest standard deviations. The mean total PES was 10.6 for the prosthodontists, 9.2 for the oral surgeons, 9.9 for the dental students and 7.6 for the orthodontists.The PES reproducibly evaluates peri-implant soft tissue around single-tooth implants. Thus, an objective outcome of different surgical or prosthodontic protocols can be assessed. Orthodontists were clearly more critical than the other observers.

The survival rate of splinted and unsplinted provisional implants for anchoring removable interim overdentures, as well as handling and maintenance of the interim dentures, was evaluated.Eighteen edentulous maxillae were provided with 72 provisional implants for anchoring interim overdentures. For 10 patients, 40 unsplinted implants were used with conical copings to retain the provisional prostheses, while for 8 patients 32 implants had a splinted bar architecture for supporting the interim prostheses. Failure rate of provisional implants, as well as handling and behavior of the anchored interim overdentures, was followed until definitive prosthetic restoration and compared between groups.Eighteen (25.0%) of the 72 provisional implants were prematurely lost. The loss rate of unsplinted implants (37.5%) was significantly higher than that of splinted implants (9.3%). Patient handling and maintenance of maxillary interim overdentures during the follow-up period was found to be easier with the splinted bar-retained method than with the unsplinted prosthodontic method.Placement of provisional implants fulfilled the requirements for initiating immediate prosthetic rehabilitation and showed that removable interim overdentures can be adequately stabilized and provide added patient comfort and satisfaction. The results suggest benefits of the splinted retention modality over the unsplinted method because of advantages regarding failure rate, patient handling, and interim denture maintenance.

Purpose Rehabilitation of the incomplete dentition by means of osseointegrated dental implants represents a highly predictable and widespread therapy; however, little is known about potential risk factors that may impair long-term implant success. Methods From 2004 to 2012, a total of 13,147 implants were placed in 4,316 patients at the Academy for Oral Implantology in Vienna. The survival rates after 8 years of follow-up were computed using the Kaplan-Meier method, and the impact of patient- and implant-related risk factors was assessed. Results Overall implant survival was 97% and was not associated with implant length (P=0.930), implant diameter (P=0.704), jaw location (P=0.545), implant position (P=0.450), local bone quality (P=0.398), previous bone augmentation surgery (P=0.617), or patient-related factors including osteoporosis (P=0.661), age (P=0.575), or diabetes mellitus (P=0.928). However, smoking increased the risk of implant failure by 3 folds (P