Fig. 5. PROMs over 5 years: improvement of satisfaction from loading to study end
Fig. 5. PROMs over 5 years: improvement of satisfaction from loading to study end
Fig. 4. Soft tissue parameters at 5-year post-loading. a Plaque index: score 0, no plaque detected; score 1, plaque only recognized by running a probe across the smooth marginal surface of the implant; score 2, plaque seen by the naked eye; score 3, abundance of soft matter. b Sulcus bleeding index: score 0, no bleeding when a periodontal probe was passed along the gingival margin adjacent to th...
Fig. 3. Standardized peri-apical radiographs representing the bone level changes at the implant level: immediately post insertion (a), at loading (abutment/crown placement) (b), and at 5-year post-loading (c)
Fig. 3. Standardized peri-apical radiographs representing the bone level changes at the implant level: immediately post insertion (a), at loading (abutment/crown placement) (b), and at 5...
Fig. 2. Kaplan-Meier cumulative survival rate
Fig. 2. Kaplan-Meier cumulative survival rate
Fig. 1. Study flow-chart: assessments and reason for dropouts. Study visits were done according to standard procedures in the respective study centers. Blue, mandatory visits; gray, optional visits
Fig. 1. Study flow-chart: assessments and reason for dropouts. Study visits were done according to standard procedures in the respective study centers. Blue, mandatory visits; gray, optional visits
Bone level changenMeanSDInsertion-loading103− 0.520.55Loading-1-year follow-up93− 0.040.37Loading-3-year follow-up90− 0.040.40Loading-5-year follow-up86− 0.090.43Table 3 Mean crestal bone level changes in mm
CharacteristicsCategoryTotalTotal patients/implantsn94/130Center 19/17Center 218/26Center 320/26Center 414/16Center 518/26Center 615/19Gender, n (%)Male30 (31.9)Female64 (68.1)Age at surgery, yearsMean ± SD50.4 ± 13.7Range (min/max)19.1-75.6Age range distribution, n (%)< 30 years8 (8.5)30-45 years22 (23.4)45-60 years38 (40.4)60-75 years25 (26.6)> 75 years1 (1.1)Tobacco use, n (%)Non-sm...
Time periodPatientsImplantsBefore loading58Loading-1 year681-3 years673-5 years13Total1826Table 1 Dropouts over observation time
Ackermann, KL., Barth, T., Cacaci, C. et al. Clinical and patient-reported outcome of implant restorations with internal conical connection in daily dental practices: prospective observational multicenter trial with up to 7-year follow-up.
Int J Implant Dent 6, 14 (2020). https://doi.org/10.1186/s40729-020-00211-z
Download citation
Received: 16 December 2019
Accepted: 12 Ma...
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material...
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
A written consent was given by all patients after being informed of the study. The study was performed following the declaration of Helsinki. Ethics committee approval was obtained from the international ethical committee of Freiburg (Germany, Ref. 010/1833).
Not applicable.
All authors declare that they have no conflicts of interest regarding this study. All authors have been lecturing for Caml...
Filderstadt, Germany
Karl-Ludwig Ackermann
Leipzig, Germany
Thomas Barth
Munich, Germany
Claudio Cacaci
Landsberg a. L., Germany
Steffen Kistler
Forchheim, Germany
Markus Schlee
Department of Maxillofacial Surgery, Goethe University Frankfurt, Frankfurt, Germany
Markus Schlee
Berlin, Germany
Michael Stiller
You can also search for this author in
PubMed Googl...
This study was funded by an unrestricted grant (NISCAM01/10) of the Oral Reconstruction Foundation (previously CAMLOG Foundation).
The authors thank Lucius Keller of Touchpoint Communication AG (Luzern, Switzerland) for the medical writing support.
Chang M, Odman PA, Wennstrom JL, Andersson B. Esthetic outcome of implant-supported single-tooth replacements assessed by the patient and by prosthodontists. Int J Prosthodont. 1999;12(4):335–41.
Kiltz U, Winter J, Schirmer M, Weber U, Hammel L, Baraliakos X, et al. German translation and cross-cultural adaptation of the ASAS health index: an ICF-based instrument for documentation of functional...
Ravald N, Dahlgren S, Teiwik A, Grondahl K. Long-term evaluation of Astra Tech and Branemark implants in patients treated with full-arch bridges. Results after 12-15 years. Clin Oral Implants Res. 2013;24(10):1144–51.
Schwarz F, Alcoforado G, Nelson K, Schaer A, Taylor T, Beuer F, et al. Impact of implant-abutment connection, positioning of the machined collar/microgap, and platform switching...
Gupta S, Sabharwal R, Nazeer J, Taneja L, Choudhury BK, Sahu S. Platform switching technique and crestal bone loss around the dental implants: a systematic review. Ann Afr Med. 2019;18(1):1–6.
Hsu YT, Lin GH, Wang HL. Effects of platform-switching on peri-implant soft and hard tissue outcomes: a systematic review and meta-analysis. Int J Oral Maxillofac Implants. 2017;32(1):e9–e24.
Nelson K,...
Cacaci C, Ackermann KL, Barth T, Kistler S, Stiller M, Schlee M. A non-interventional multicenter study to document the implants success and survival rates in daily dental practices of the CONELOG screw-line implant. Clin Oral Investig. 2019;23(6):2609–16.
Cochran D, Oates T, Morton D, Jones A, Buser D, Peters F. Clinical field trial examining an implant with a sand-blasted, acid-etched surface...
Krennmair G, Seemann R, Weinlander M, Piehslinger E. Comparison of ball and telescopic crown attachments in implant-retained mandibular overdentures: a 5-year prospective study. Int J Oral Maxillofac Implants. 2011;26(3):598–606.
Slot W, Raghoebar GM, Cune MS, Vissink A, Meijer HJA. Four or six implants in the maxillary posterior region to support an overdenture: 5-year results from a randomize...
Adverse event
Bone level change
Distance implant shoulder to first visible bone contact
Orthopantomogram
Plaque index
Patient reported outcome measures
Platform switching
Sulcus bleeding index
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
This prospective observational multicenter study demonstrated successful functional and esthetic outcomes of the study implant restorations (single tooth restoration, fixed partial dentures) with reliable peri-implant hard and soft tissue stability and high patients’ satisfaction. The results are comparable with the outcome of already published controlled randomized clinical studies and retrospe...
In recent years, patients’ needs have increased in terms of the esthetic and functional outcome of the dental restoration. PROMs have been reported in several studies and represent a well-described non-invasive method to measure patient’s satisfaction with these needs; however, they might present a lack of standardization [39, 40] due to the very subjective view on esthetics or functionality o...
Changes in crestal bone level are well-documented in the literature. Bone remodeling is reported to take place between surgery and loading. The reported changes are generally around 0.5 mm [17, 27, 30] but can reach more than 1 mm [31] in randomized or observational trials. The present study is well in accordance with these findings with its bone remodeling of − 0.52 ± 0.55 mm. Nearly 45%...
Endosseous dental implants are a commonly accepted treatment procedure and showed high survival and success rates as well as good functional performance in numerous clinical trials and retrospective analyses, also for Conelog implants as for their specific implant surface [17, 23, 26]. However, in general, one could argue that results of controlled clinical studies do not reflect the real situatio...
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 g...
The study was started with 94 patients with 130 implants. At the end of the study (5-year post-loading), 76 patients with 104 implants were considered for analysis. Dropouts were distributed over the time of the study as described in Table 1. The majority of dropouts occurred early in the study phase. The reasons for the dropouts were variable as described in Fig. 1.
The demographic and clinica...
The study data, soft and hard tissue parameters as well as the PROMs were descriptively analyzed using IBM SPSS V25.0 (IBM Corp., Armonk, NY, USA): Categorical variables were shown with frequencies and mean values were used for continuous variables. Survival analysis was performed using Kaplan–Meier method. Time of loading was the study baseline as per protocol, and the statistical unit was the ...
Patients were scheduled to follow-ups at 6 months, 1-, 2-, 3-, 4-, and 5-year post-loading for the assessment of the study parameter (Fig. 1). Depending on the investigators’ standard post-operative protocol, follow-up appointments were scheduled slightly differently: One center skipped the control visits at 6 months. Additionally, due to the observational character of the study and the pati...
This is an observational multicenter clinical study, approved by the ethics committee of the Freiburg ethics commission international (feci 010/1833). The study was planned and conducted according to the German medical devices law, the Declaration of Helsinki, good clinical practice, and the reporting is aligned with the STROBE statement. A minimum of 90 to 100 patients were planned to be included...
Features of the chosen implant system for a study may also influence the outcome of the treatment: The degree of the manufacturer’s tolerances of implants with a conical implant-abutment connection heightens the risk of a mispositioning of the abutment, which cannot be corrected by repeated torqueing. Platform switching (PS) implants tend to have a protective effect on hard implant tissue outcom...
Many randomized controlled clinical trials have been published about dental implants. They have demonstrated long-term success in the rehabilitation of edentulous patients [1, 2] as well as patients with single or multiple teeth replacements [3, 4].
While this type of trials have an indispensable place in establishing a new product or a new operation technique regarding safety and efficacy, the r...
The interpretation of the results of randomized clinical trials is often questioned in relation with daily circumstances in practices. This prospective observational multicenter study was instigated to reflect the need for information in real-life situations with dental implants with internal conical implant-abutment connection (Conelog implant system). The implants were followed up at least 5-yea...
Fig. 5. PROMs over 5 years: improvement of satisfaction from loading to study end
Fig. 5. PROMs over 5 years: improvement of satisfaction from loading to study end
Fig. 4. Soft tissue parameters at 5-year post-loading. a Plaque index: score 0, no plaque detected; score 1, plaque only recognized by running a probe across the smooth marginal surface of the implant; score 2, plaque seen by the naked eye; score 3, abundance of soft matter. b Sulcus bleeding index: score 0, no bleeding when a periodontal probe was passed along the gingival margin adjacent to th...
Fig. 3. Standardized peri-apical radiographs representing the bone level changes at the implant level: immediately post insertion (a), at loading (abutment/crown placement) (b), and at 5-year post-loading (c)
Fig. 3. Standardized peri-apical radiographs representing the bone level changes at the implant level: immediately post insertion (a), at loading (abutment/crown placement) (b), and at 5...
Fig. 2. Kaplan-Meier cumulative survival rate
Fig. 2. Kaplan-Meier cumulative survival rate
Fig. 1. Study flow-chart: assessments and reason for dropouts. Study visits were done according to standard procedures in the respective study centers. Blue, mandatory visits; gray, optional visits
Fig. 1. Study flow-chart: assessments and reason for dropouts. Study visits were done according to standard procedures in the respective study centers. Blue, mandatory visits; gray, optional visits
Bone level changenMeanSDInsertion-loading103− 0.520.55Loading-1-year follow-up93− 0.040.37Loading-3-year follow-up90− 0.040.40Loading-5-year follow-up86− 0.090.43Table 3 Mean crestal bone level changes in mm
CharacteristicsCategoryTotalTotal patients/implantsn94/130Center 19/17Center 218/26Center 320/26Center 414/16Center 518/26Center 615/19Gender, n (%)Male30 (31.9)Female64 (68.1)Age at surgery, yearsMean ± SD50.4 ± 13.7Range (min/max)19.1-75.6Age range distribution, n (%)< 30 years8 (8.5)30-45 years22 (23.4)45-60 years38 (40.4)60-75 years25 (26.6)> 75 years1 (1.1)Tobacco use, n (%)Non-sm...
Time periodPatientsImplantsBefore loading58Loading-1 year681-3 years673-5 years13Total1826Table 1 Dropouts over observation time
Ackermann, KL., Barth, T., Cacaci, C. et al. Clinical and patient-reported outcome of implant restorations with internal conical connection in daily dental practices: prospective observational multicenter trial with up to 7-year follow-up.
Int J Implant Dent 6, 14 (2020). https://doi.org/10.1186/s40729-020-00211-z
Download citation
Received: 16 December 2019
Accepted: 12 Ma...
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material...
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
A written consent was given by all patients after being informed of the study. The study was performed following the declaration of Helsinki. Ethics committee approval was obtained from the international ethical committee of Freiburg (Germany, Ref. 010/1833).
Not applicable.
All authors declare that they have no conflicts of interest regarding this study. All authors have been lecturing for Caml...
Filderstadt, Germany
Karl-Ludwig Ackermann
Leipzig, Germany
Thomas Barth
Munich, Germany
Claudio Cacaci
Landsberg a. L., Germany
Steffen Kistler
Forchheim, Germany
Markus Schlee
Department of Maxillofacial Surgery, Goethe University Frankfurt, Frankfurt, Germany
Markus Schlee
Berlin, Germany
Michael Stiller
You can also search for this author in
PubMed Googl...
This study was funded by an unrestricted grant (NISCAM01/10) of the Oral Reconstruction Foundation (previously CAMLOG Foundation).
The authors thank Lucius Keller of Touchpoint Communication AG (Luzern, Switzerland) for the medical writing support.
Chang M, Odman PA, Wennstrom JL, Andersson B. Esthetic outcome of implant-supported single-tooth replacements assessed by the patient and by prosthodontists. Int J Prosthodont. 1999;12(4):335–41.
Kiltz U, Winter J, Schirmer M, Weber U, Hammel L, Baraliakos X, et al. German translation and cross-cultural adaptation of the ASAS health index: an ICF-based instrument for documentation of functional...
Ravald N, Dahlgren S, Teiwik A, Grondahl K. Long-term evaluation of Astra Tech and Branemark implants in patients treated with full-arch bridges. Results after 12-15 years. Clin Oral Implants Res. 2013;24(10):1144–51.
Schwarz F, Alcoforado G, Nelson K, Schaer A, Taylor T, Beuer F, et al. Impact of implant-abutment connection, positioning of the machined collar/microgap, and platform switching...
Gupta S, Sabharwal R, Nazeer J, Taneja L, Choudhury BK, Sahu S. Platform switching technique and crestal bone loss around the dental implants: a systematic review. Ann Afr Med. 2019;18(1):1–6.
Hsu YT, Lin GH, Wang HL. Effects of platform-switching on peri-implant soft and hard tissue outcomes: a systematic review and meta-analysis. Int J Oral Maxillofac Implants. 2017;32(1):e9–e24.
Nelson K,...
Cacaci C, Ackermann KL, Barth T, Kistler S, Stiller M, Schlee M. A non-interventional multicenter study to document the implants success and survival rates in daily dental practices of the CONELOG screw-line implant. Clin Oral Investig. 2019;23(6):2609–16.
Cochran D, Oates T, Morton D, Jones A, Buser D, Peters F. Clinical field trial examining an implant with a sand-blasted, acid-etched surface...
Krennmair G, Seemann R, Weinlander M, Piehslinger E. Comparison of ball and telescopic crown attachments in implant-retained mandibular overdentures: a 5-year prospective study. Int J Oral Maxillofac Implants. 2011;26(3):598–606.
Slot W, Raghoebar GM, Cune MS, Vissink A, Meijer HJA. Four or six implants in the maxillary posterior region to support an overdenture: 5-year results from a randomize...
Adverse event
Bone level change
Distance implant shoulder to first visible bone contact
Orthopantomogram
Plaque index
Patient reported outcome measures
Platform switching
Sulcus bleeding index
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
This prospective observational multicenter study demonstrated successful functional and esthetic outcomes of the study implant restorations (single tooth restoration, fixed partial dentures) with reliable peri-implant hard and soft tissue stability and high patients’ satisfaction. The results are comparable with the outcome of already published controlled randomized clinical studies and retrospe...
In recent years, patients’ needs have increased in terms of the esthetic and functional outcome of the dental restoration. PROMs have been reported in several studies and represent a well-described non-invasive method to measure patient’s satisfaction with these needs; however, they might present a lack of standardization [39, 40] due to the very subjective view on esthetics or functionality o...
Changes in crestal bone level are well-documented in the literature. Bone remodeling is reported to take place between surgery and loading. The reported changes are generally around 0.5 mm [17, 27, 30] but can reach more than 1 mm [31] in randomized or observational trials. The present study is well in accordance with these findings with its bone remodeling of − 0.52 ± 0.55 mm. Nearly 45%...
Endosseous dental implants are a commonly accepted treatment procedure and showed high survival and success rates as well as good functional performance in numerous clinical trials and retrospective analyses, also for Conelog implants as for their specific implant surface [17, 23, 26]. However, in general, one could argue that results of controlled clinical studies do not reflect the real situatio...
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 g...
The study was started with 94 patients with 130 implants. At the end of the study (5-year post-loading), 76 patients with 104 implants were considered for analysis. Dropouts were distributed over the time of the study as described in Table 1. The majority of dropouts occurred early in the study phase. The reasons for the dropouts were variable as described in Fig. 1.
The demographic and clinica...
The study data, soft and hard tissue parameters as well as the PROMs were descriptively analyzed using IBM SPSS V25.0 (IBM Corp., Armonk, NY, USA): Categorical variables were shown with frequencies and mean values were used for continuous variables. Survival analysis was performed using Kaplan–Meier method. Time of loading was the study baseline as per protocol, and the statistical unit was the ...
Patients were scheduled to follow-ups at 6 months, 1-, 2-, 3-, 4-, and 5-year post-loading for the assessment of the study parameter (Fig. 1). Depending on the investigators’ standard post-operative protocol, follow-up appointments were scheduled slightly differently: One center skipped the control visits at 6 months. Additionally, due to the observational character of the study and the pati...
This is an observational multicenter clinical study, approved by the ethics committee of the Freiburg ethics commission international (feci 010/1833). The study was planned and conducted according to the German medical devices law, the Declaration of Helsinki, good clinical practice, and the reporting is aligned with the STROBE statement. A minimum of 90 to 100 patients were planned to be included...
Features of the chosen implant system for a study may also influence the outcome of the treatment: The degree of the manufacturer’s tolerances of implants with a conical implant-abutment connection heightens the risk of a mispositioning of the abutment, which cannot be corrected by repeated torqueing. Platform switching (PS) implants tend to have a protective effect on hard implant tissue outcom...
Many randomized controlled clinical trials have been published about dental implants. They have demonstrated long-term success in the rehabilitation of edentulous patients [1, 2] as well as patients with single or multiple teeth replacements [3, 4].
While this type of trials have an indispensable place in establishing a new product or a new operation technique regarding safety and efficacy, the r...
The interpretation of the results of randomized clinical trials is often questioned in relation with daily circumstances in practices. This prospective observational multicenter study was instigated to reflect the need for information in real-life situations with dental implants with internal conical implant-abutment connection (Conelog implant system). The implants were followed up at least 5-yea...