Care and aftercare related to implant-retained dental crowns in the maxillary aesthetic region: a 5-year prospective randomized clinical trial.

AIM: To prospectively assess surgical and prosthetic care and aftercare related to the placement of implant-retained dental crowns after local bone augmentation in patients missing one tooth in the maxillary aesthetic region.

METHODS: Ninety-three patients were randomly allocated to one of three local augmentation groups: (1) chin bone; (2) chin bone covered by a Bio-Gide® membrane (Geistlich, Wolhusen, Switzerland); and (3) Bio-Oss® covered by a Bio-Gide® membrane. After local augmentation, implant placement (ITI) and fabrication of an implant-retained dental crown (cemented metal-ceramic dental crown) was performed. Prosthetic and surgical care and aftercare was scored from the first visit until 5 years after the augmentation of the implant region.

RESULTS: The need for care and aftercare was comparable between the local augmentation groups. Three implants were lost (5-year implant survival rate: 96.7%). Surgical aftercare was needed in 9% of patients and consisted of care related to peri-implant tissue problems. Prosthetic aftercare was needed more often: all patients needed periodic routine inspections; 63% needed supplemental oral hygiene support; and 16% needed additional prosthetic care, mainly consisting of fabricating new crowns (12%).

CONCLUSION: Placing an implant in the maxillary esthetic region after local bone augmentation is a safe and reliable treatment option not needing much specific aftercare other than periodic preventive routine inspections, routine oral hygiene care, and fabrication of a new crown in one out of every eight to nine patients in 5 years. The method used for augmentation was irrespective of the patients' need for aftercare.