Immediate provisionalization of bone level implants with a hydrophilic surface. A five-year follow-up of a randomized controlled clinical trial

Objectives To follow-up the radiographic bone level changes and the clinical outcomes of immediately provisionalized and conventionally restored implants with a hydrophilic surface following 5 years of function. Materials and methods This was a 5-year follow-up of a prospective, randomized, single-blind controlled study involving 16 of the 24 originally recruited patients in need of a single-tooth replacement in the esthetic area. Implants were either immediately provisionalized with a non-occluding temporary crown (test group, n = 7), or left without a crown (control group, n = 9). In both groups, the definitive restoration was placed 16 weeks after implant placement. Radiographic and clinical parameters were evaluated at 36, 48, and 60 months post-implant placement, together with implant survival and success rates. The esthetic outcomes were measured with the Papilla Fill Index (PFI) and the Pink Esthetic Score (PES). Results At 60 months, similar peri-implant bone loss was observed in the test (-0.42 mm +/- 0.17 mm) and in the control (-0.37 mm +/- 0.35 mm) groups. A tendency for an improved esthetic outcome from implant loading to the subsequent follow-ups was noticed in both groups. Both groups presented with high levels of long-term implant survival and success. Conclusions This study supports non-functional immediate provisionalization as a viable long-term option for the management of single-tooth implants in the esthetic area. However, the small sample size does not allow statistical inference at 60 months of follow-up and future adequately powered studies are warranted.