Caroliene Meijndert

160 Addendum Summary Single tooth replacement in the aesthetic region has been part of implant dentistry for a number of decades. Since its introduction, many implant systems, surgical and prosthetic techniques, and loading protocols have been used. The goal of dental implant therapy in the aesthetic region is to achieve successful tissue integration, with predictable and aesthetically acceptable hard and soft tissue contours, thus re- establishing both function and aesthetics. The results should not just be a short term achievement, but should remain stable in the long term. Therefore, the general aim of this thesis was to assess the outcomes of implant treatment for a missing tooth in the aesthetic region in both shortterm and longterm follow-up. The patients in the various studies described in this thesis had different grades of alveolar bone resorption, and requested implant therapy for one missing or failing tooth. Different implant designs were applied, the choice being based on the best suitable Straumann implant system (ITI dental implant system) available at the time. In the study described in chapter 2 , we aimed to assess the 10-year effects of three different augmentation techniques (augmentation with chin bone, augmentation with chin bone plus a membrane, and augmentation with a bone substitute plus a membrane) for implant-supported restorations in the maxillary aesthetic region. The clinical and radiographic parameters, as well as the patient-centred outcomes, were noted. Ninety-three participants (44 male/49 female, mean age 33 years) requesting single tooth replacement, and presenting with a horizontal bone deficiency, were included. Six months after the augmentation with either of the three augmentation techniques, tissue level implants were placed. All 93 implants were provisionalized after 6 months of submerged healing. Clinical variables, standardized radiographs and photographs, and patient questionnaires were analysed to assess the impact of the various augmentation techniques one month (T 1 ), 12 months (T 12 ) and 120 months (T 120 ) after final crown placement. The ten-year implant survival was 95.7% and did not differ between the groups, neither were there significant differences observed in the other assessed treatment outcomes. Peri-implant bone loss was low, viz. 0.48±1.19 mm (mesially) and 0.30±1.24 mm (distally) at T 120 . The mid-buccal marginal gingival level loss was 0.32±0.83 mm at T 120 . The mean overall satisfaction was 8.6 (on a scale from 0-10) at T 120 , with 98.6% of the patients being satisfied. It was concluded that the clinical, radiographic, aesthetic and patient-centred outcomes were very favourable after 10 years and did not differ between the groups with different bone augmentation techniques.