Single implants in the upper incisor region and their relationship to the adjacent teeth. An 8-year follow-up study

The aim of the study was to find out if implant-supported crowns in the upper incisor region run the risk of coming into an infraoccluded position later in life. Ten adolescents with 15 implant-supported crowns were included in the study. The age of the patients at the implant surgery ranged between 14 and 19 years. They were followed up during an 8-year period. No implant loss was observed. A good or acceptable aesthetic appearance at the last observation was found in most subjects. In some of them a change in the vertical position of the implant-supported crown, resulting in infraocclusion, could be registered, especially in subjects with no incisor contact. Throughout the follow-up period, only minor loss of marginal bone support was observed at the implants. At the teeth adjacent to the implant, a reduction of the marginal bone level was observed in some patients. Of importance to consider in single implant therapy is that a fixed chronological age is no guidance for implant placement, due to a slight continuous eruption of the adjacent teeth post adolescence. An orthodontic treatment should be performed not only in order to gain space in the implant area, but also to attain good incisor stability to reduce the risk of infraocclusion of the implant-supported crown. Furthermore, 3 cases will exemplify that infraocclusion also may occur in patients who had received single implants at adult ages.