Table 3 shows the mean bone level changes of the implants with available radiographs from insertion to 5-year post-loading. Bone remodeling around the implant was noticeable from surgery to loading, presenting a mean value of − 0.52 ± 0.55 mm. From loading to the 5-year follow-up, the mean change in crestal bone remained clinically stable (−0.09 ± 0.43 mm) (Fig. 3).

Split into three groups, at 5-year post-loading, 15.1% of the implants were noted with a noticeable bone gain, 61.6% of the implants revealed a change in bone level of no clinical relevance (± 0.25 mm) and 23.3% of the implants experienced bone loss (> 0.25 mm).

Oral hygiene status at 5-year post-loading is shown in Fig. 4. The general oral situation was subjectively assessed by the investigators at each visit after dental check-up based on the patients’ oral care behavior, tartar, and plaque. Before implantation, 31.9% of the patients presented an excellent, 66.0% a good, and 2.1% a fair oral hygiene. At the last follow-up, 28.8% of the patients presented an excellent, 61.6% a good, 8.2% a fair, and 1.4% a poor oral hygiene. This still excellent oral hygiene status at 5-year post-loading is congruent with the plaque and sulcus bleeding index: 96% of the implants were noted with no or only few plaque (scores 0 and 1), and 99% of the implants revealed no bleeding or only isolated bleeding spots upon probing (Fig. 4).

At the follow-up at 3-year post-loading, on a category scale of 1 (maximal satisfied) to 5 (very unsatisfied), 82.3% of the patients rated their general satisfaction as maximally satisfied, while 16.1% scored as satisfied. One patient (1.6%) rated his general satisfaction as neither satisfied nor unsatisfied due to esthetic problems induced by peri-implant hard and soft tissue recession. The same patient rated the appearance as unsatisfied (Fig. 5). At the last follow-up at 5 years, all the parameters of satisfaction improved to their maximum (general satisfaction: 87.5% of the patients were very satisfied and 12.5% satisfied).