Prosthodontist and former chairman, Specialist Clinic of Prosthetic Dentistry, Public Dental Health Service, Mölndal Hospital, Västra Götaland, Sweden Prosthodontist, Specialist Clinic of Prosthetic Dentistry, Public Dental Health Service, Mölndal Hospital, Västra Götaland, Sweden Chairman, Specialist Clinic of Prosthetic Dentistry, Public Dental Health Service, Mölndal Hospital, Västra Götaland, Sweden Prosthodontis and former chairman, Brånemark Clinic, Public Dental Health Service, Västra Götaland, Sweden, and professor, Department of Prosthetic Dentistry/Dental Material Science, Institute of Odontology, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
Background: Various levels of infraposition of single-implant restorations have been observed in long-term follow-up studies, but little knowledge is available on the biological mechanism behind this pattern. Purpose: The primary aim of this study is to report the frequency and severeness of implant infraposition in the anterior single-implant application after 17 to 19 years in function and, secondly, to try to relate these observations to anatomical appearance of the shape of the face of the patient. Materials and Methods: The present study comprised of 57 patients who were provided with 65 CeraOne™ single-tooth restorations (Nobel Biocare AB, Gothenburg, Sweden) between 1989 and 1991. Altogether 46 of these patients were treated with single implants in the anterior region. Besides clinical and radiographic data, clinical photographs, study casts, and patient's assessment of the long-term aesthetic result (visual analog scale) was collected at the termination of the present study. The degree of implant crown infraposition was related to assessed facial shape and to patient and clinical assessment of the aesthetic result by means of Pearson's correlation test. To increase the numbers of patients, another group of 25 patients presented in another similar study were pooled with the present material for prevalence calculations. Results: Altogether 47 patients showed up for the final examination after an average of 18 years (82%). Two implants failed (18 years cumulative survival rates [CSR]- 96.8%) and eight original single-crown restorations were replaced (CSR 83.8%). Three of the replaced crowns were replaced because of infraposition of the crowns. About 40% of the patients showed signs of infraposition, similar in younger and older age groups, but more frequently observed in female patients at termination of the study (p 0.05), and patients were more satisfied with the aesthetic clinical result than the participating clinicians (p 0.05). Patients were more satisfied with the aesthetic result, as compared with the clinicians (p