Marginal bone and soft tissue alterations after use of OsseoSpeed Profile EV implants

Background: Horizontal bone defect is an indication for bone augmentation during implantation. An alternative to this standard procedure is to use of an implant with a sloped shoulder matching differences in height between lingual and buccal bone crest. Therefore the advantage of using this implant is that there is no need for bone augmentation procedures. On the other hand, giving up augmentation, offers no chance to improve anatomical conditions in order to achieve stable level of bone and soft tissues. Aim/Hypothesis: The purpose of the study was evaluation of the marginal bone and soft tissue alterations after the OsseoSpeed Profile EV implants placement. Materials and Methods: Thirty patients aged 25-81 years with a need for a single tooth replacement in the area from the central incisor to the first molar in the upper jaw and from the central incisor to the second premolar in the mandible were qualified for the study. The inclusion criteria was the presence of the site demonstrating a lingual-buccal bone height discrepancy of 2.0-3.0 mm visible in CBCT. OsseoSpeed Profile EV implants were inserted at bone level or slightly subcrestally. The implants were loaded with a temporary crown 3 months after implantation, followed by a definitive crown six months after implantation. The study assumed CBCT assessment immediately after implantation and after the placement of a temporary crown. The distance between the implant platform and the bone margin and the thickness of buccal and palatal plates 3 mm apical from the implant platform were examined. Also pink esthetic score (PES) and papilla index (PI) after the temporary and final crown installation were evaluated. Results: No patient had buccal or palatal plate dehiscence detected in the CBCT after a temporary crown installation. The mean thickness of the buccal plate was 1.99 (1.05) mm at the time of implantation, and after delivery of the temporary crown 1.67 (1.05) mm (P = 0.0077). Mean palatal plate thickness was 2.55 (1.01) mm and 2.60 (1.07) mm, respectively (P = 0.47). After delivery of the temporary crown PES range was 3-8 (Me = 5) and after delivery of the definitive crown 4-8 (Me = 6) (P = 0.0007). Papilla index for mesial (PIm) range was 0-2 after the temporary crown (Me = 1) and 1-3 after the definitive crown installation (Me = 1.25) (P = 0.0005). Papilla index for distal (PId) range was between 0-2 (Me = 1) and 0-3 (Me = 1) (P = 0.0034) respectively. Conclusions and Clinical Implications: The use of an implant with a sloped platform does not adversely affect the surrounding bone and soft tissues. Keywords: Implant, CBCT, pink esthetic score, papilla index