Tissue-level versus bone-level single implants in the anterior area rehabilitated with feather-edge crowns on conical implant abutments: An up to 5-year retrospective study.

Limited information is available on the differences between tissue-level implants with an ultrathin threaded microsurface conical transmucosal portion and bone-level implants rehabilitated with conical custom abutments. The purpose of this retrospective study was to assess the outcomes of crowns designed as per the biologically oriented preparation technique (BOPT) cemented on conical titanium abutments on tissue-level and bone-level implants. Patients consecutively rehabilitated with a delayed loading protocol with anterior implant-supported single crowns with a feather-edge margin, in function for at least 4 years, were recruited and divided into 2 groups based on the implant type they had received: tissue-level implants with a conical transmucosal portion or bone-level implants rehabilitated with a conical abutment by following the platform switching concept. Bone resorption, pink esthetic score (PES), and white esthetic score (WES) were collected and analyzed. The nonparametric Mann-Whitney test was performed to analyze all parameters (α=.05 for all tests). A total of 43 participants (48 implants) were included in the present study. The mean follow-up period was 4.5 years (range 52-64 months). A statistically significant difference (P=.004) was found in the mean ±standard deviation bone resorption between tissue-level implants (0.38 ±0.46 mm) and bone-level implants (0.83 ±0.58 mm). Higher values for both PES and WES were obtained in the tissue-level implant group. Within the limitations of the present retrospective study, tissue-level implants with a conical transmucosal portion seem to provide a suitable alternative to bone-level implants in the anterior area.

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