A 5 to 7-year case series on single angulated implants installed following papilla-sparing flap elevation

Background: Bony concavities at the buccal aspect may cause a distortion between the implant axis and ideal prosthetic axis. Angulated implants can overcome this problem, yet long-term data are lacking. In addition, papilla-sparing incisions have been proposed to reduce tissue loss, yet aesthetic outcomes have not been published. Purpose: To evaluate the 5 to 7-year outcome of single angulated implants installed following papilla-sparing flap elevation. Materials and Methods: Patients who had been consecutively treated with a single angulated implant (Co-axis®, Southern Implants, Irene, South Africa) in the anterior maxilla were re-examined after 5 to 7 years. Available data at 1 year (T1) were compared to those obtained at 5 to 7 years (T2). Results: Twenty out of 22 treated patients (11 females, 9 males, mean age of 52) with 22 implants attended the 5 to 7-year reassessment. All implants survived and stable clinical conditions could be reached with mean marginal bone loss of 1.28 mm at T2. Papilla-sparing flap elevation resulted in Pink Esthetic Score of 9.83 at T1 and 8.23 at T2 (p = 0.072). Mucosal Scarring Index was 4.61 at T1 and 3.50 at T2 (p = 0.165). The overall appearance of scarring significantly improved over time (p = 0.032), yet 59% of the cases still demonstrated scarring at T2.c. Conclusions: Within the limitations of the study, angulated implants (Co-axis®, Southern Implants) reached stable clinical conditions. Papilla-sparing incisions may not be recommended in aesthetically demanding patients due to high risk of scarring.