***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES the aim of this r and omized-controlled clinical trial was to compare the objective and subjective esthetic outcomes of two types of  screwed-retained single-implant crowns .  MATERIAL S AND METHODS participants were r and omly assigned to the test ( all-ceramic ) and control [ porcelain-fused-to-ceramic ( PFM ) ] groups and were seen under investigation at baseline ( B ) , crown insertion ( CI ) , 1-year follow-up ( 1Y ) , and 2-year follow-up ( 2Y ) . Objective parameters were assessed by an intra-oral digital photograph ( 1:1 ratio ) , a study cast , a st and ardized radiograph , periodontal/peri-implant measurements , and question naires were obtained for the subjective parameters . In addition , pink esthetic score ( PES ) and white esthetic score ( WES ) were calculated for both groups . For the subjective evaluation , a visual analogue scale ( VAS ) question naire was used to assess the level of patient satisfaction regarding the esthetic outcome . Then , nine expert clinicians visually inspected and assessed subjective evaluation at the professional level . Statistical analysis was used to compare between groups and investigational appointments . RESULTS twenty patients were included in the study , 10 allocated to the all-ceramic group and 10 to the PFM group . No statistically significant differences were observed for the objective measurements comparing the test and control groups . Minor chipping of the ceramic veneering material was observed in the two patients of control group . The mean difference for all groups comparing objective parameters revealed an increase of papilla height between time points . A slight recession ( 0.26 mm ) of the peri-implant mucosal margin at the implant site was observed between 1Y and 2Y . Mean values for PES and WES were 13.9 and 13.1 for the PFM group and for the all-ceramic group , respectively . These values were not statistically significant . Implant crown volume , outline , translucency , and characterization showed major discrepancies with the contra-lateral natural teeth . As for subjective parameters , VAS patients ' responses regarding their perceptions of the esthetic outcome showed no statistical differences between groups and clinicians ' accuracy scores were 50 % and 47 % for PFM and all-ceramic crowns , respectively . CONCLUSION PFM and all-ceramic single-implant restorations may be indistinguishable from each other regarding the objective /subjective assessment of esthetic integration . The material chosen for fabricating an implant crown per se does not ensure an optimal esthetic outcome if other esthetic parameters are not present OBJECTIVES The aim of this study was to evaluate the aesthetics of implant-supported single-tooth replacements using different augmentation procedures in a prospect i ve study with the use of an objective rating index and with a subjective patient question naire , and to compare the results with each other . MATERIAL AND METHODS Ninety-three patients with a single-tooth gap in the anterior zone of the maxilla were selected for the study . All patients had a local bone defect that needed augmentation before placement of an endosseous implant with sufficient initial stability .  Aesthetics of the implant-supported crown and adjacent mucosa was rated by a prosthodontist 1 year after placement of the porcelain crown .  Aesthetics was rated using the Implant Crown Aesthetic Index  . A subjective appreciation of the final result was assessed with a patient question naire . RESULTS The Implant Crown Aesthetic Index reveals a mean overall score of 4.8 , with an acceptable result in 66 % of the cases . Results of the satisfaction question naire reveal a mean overall score of 8.5 with an acceptable result in 100 % of the cases . There is no correlation between results of the Index and the question naire for the overall and the crown score . The patients ' opinion and the professionals ' opinion about the peri-implant mucosa do show a significant correlation . CONCLUSIONS The peri-implant mucosa is rated as less satisfactory than the implant-supported crown by both the dental professional and patients . The dental professional was less satisfied with respect to the total result and results of the crown than the patients PURPOSE To compare the outcome of immediately loaded  single implants  inserted with medium ( from 25 to 35 Ncm ) or high insertion torques ( > 80 Ncm ) . MATERIAL S AND METHODS Fifty patients received two single non-adjacent implants  , each r and omly inserted flapless with a torque between 25 to 35 Ncm or > 80 Ncm according to a split-mouth design . Non-occluding temporary crowns were immediately placed on provisional abutments and definitive crowns were delivered after 6 weeks . Patients were followed for 6 months after initial loading . Outcome measures were crown/implant failures , complications , peri-implant marginal bone level changes , postoperative pain and presence of peri-implant apical radiolucency . RESULTS No drop-out occurred . Seven implants inserted with a torque between 25 to 35 Ncm failed versus none of the implants inserted with a torque > 35 Ncm . With the exception of crown/implant failures ( exact McNemar significance P = 0.0156 , difference in proportions : -0.12 ; 95 % CI -0.21 to -0.02 ) there were no statistically significant differences between groups for the other outcome measures . CONCLUSIONS It is preferable to insert single implants with a high insertion torque ( > 80 Ncm ) , to minimise early implant failures , when loading them immediately OBJECTIVES The aim of the present study was to evaluate the outcome of immediate functional loading of implants in single-tooth replacement using two different installation procedures . MATERIAL AND METHODS One hundred and fifty-one subjects , who required single-tooth rehabilitation in the area of 15 - 25 and 35 - 45 , were enrolled in eight private clinics in Italy . The implant sites were r and omly allocated to one of the following treatment groups . In the control group , in which a st and ard preparation procedure for implant placement and submerged healing of the implant was used , abutment connection and loading of the implants were performed 3 months after installation . In the test group 1 , a st and ard preparation procedure for the implant placement and immediate functional loading of implant was carried out . In the test 2 group , however , a modified implant installation procedure ( osteotome technique ) was used followed by immediate functional loading of the implant . Clinical and radiographic examinations were performed at 3 and 12 months of follow-up at all sites . RESULTS Three implants ( 5.5 % ) from the test 2 group ( osteotome preparation ) and one ( 2 % ) from the test 1 group ( conventional drill preparation ) failed to integrate and were removed one and three months after implant installation . The mean marginal bone loss assessed at 12 months was 0.31 mm ( test 1 ) , 0.25 mm ( test 2 ) and 0.38 mm ( control ) ( no statistically significant differences were found between the three treatment groups . ) CONCLUSION It is suggested that immediate functional loading of implants that are placed with a conventional installation technique and with sufficient primary stability may be considered as a valid treatment alternative in a single-tooth replacement AIM The purpose of this prospect i ve study was to evaluate radiographic , clinical and aesthetic outcomes and patient satisfaction of cases treated with  platform-switched single implant restorations in the aesthetic region of the maxilla . Furthermore , the influence of an augmentation procedure 3 months before implant placement and the type of restoration ( screw-retained vs. cement-retained ) was evaluated . MATERIAL AND METHODS Sixty patients with a missing anterior tooth in the maxilla were treated with a Straumann Bone Level Implant . Bone augmentation was performed in 29 patients at 3 months before implant placement . Implants were loaded after 3 months of submerged healing . Follow-up was conducted at 7 and 18 months after implant placement . Peri-implant mucosa and implant crown aesthetic outcomes were determined using the Implant Crown Aesthetic Index ( ICAI ) and the Pink Esthetic Score-White Esthetic Score ( PES-WES ) . RESULTS No implants were lost . At 18 months after implant placement , mean bone level change was -0.10 ± 0.27 mm and mean probing pocket depth was 2.57 mm . No differences were found between augmented and nonaugmented sites ( P = 0.28 ) . The ICAI indicated satisfactory mucosa and crown aesthetics in 67 % and 75 % of the cases , respectively , while the PES score was 14.4 . ICAI mucosa ( P = 0.004 ) and PES ( P = 0.02 ) scores were significantly less favourable for augmented sites compared with nonaugmented sites . Patient satisfaction was high ( 8.9 ± 1.1 on VAS-score ) . CONCLUSIONS From the present prospect i ve , clinical study , it can be concluded that the Straumann Bone Level Implant shows an excellent survival rate , marginal bone stability and good clinical and aesthetic results . Bone augmentation before implant placement does not lead to more marginal bone loss . However , less favourable pink aesthetic outcomes were found in augmented sites compared with nonaugmented sites , while no differences were found between cement-retained and screw-retained restorations PURPOSE The primary goal of this stratified r and omized controlled trial ( S RCT ) was to compare the stability of  dental implants  placed under three different loading regimens during the first 16 weeks of healing following implant placement . Implants were loaded immediately , early ( 6 weeks ) , or with conventional/delayed timing ( 12 weeks ) . Secondary outcomes were to compare marginal bone adaptation for 3 years after placement . MATERIAL S AND METHODS Single posterior implant sites in the maxilla or m and ible were examined . The insertion torque value was the primary determinant of load assignment . Resonance frequency analysis was performed at follow-up appointments for the first 16 weeks ( with results provided as implant stability quotients [ ISQs ] ) . Marginal bone levels were assessed via radiographs . RESULTS Forty patients each received a single 4.0-mm diameter dental implant between 2004 and 2007 . One implant failure occurred in Lekholm and Zarb type 4 bone with insertion torque value ( ITV ) of < 8.1 Ncm ; the cumulative success rate was 97.5 % . All implants , when classified by bone and loading type , increased in stability over time , with a minor reduction of 1.3 ISQ units seen at 4 weeks in the immediate loading group . The mean marginal bone loss over 3 years was 0.22 mm . The mean ITVs at implant placement for bone types 1 and 2 ( grouped together ) , 3 , and 4 were 32 , 17 , and 10 , respectively , and were significantly different ( P < .05 ) . CONCLUSIONS ITV was a good objective measure of bone type . Using an ITV of 20 Ncm as the determinant for immediate loading and an ITV of 10 Ncm or greater as the determinant for early loading provided long-term success for this implant and led to no negative changes in tissue response . All bone type groups and loading groups showed no reduction in stability during the first 4 months of healing PURPOSE The possibility of expediting dental implant therapy by early or immediate loading protocol s requires long-term clinical investigation . The aim of this prospect i ve cohort trial was to determine the 3-year implant success rate and prosthesis complications associated with functional loading 3 weeks after 1-stage placement of Astra Tech single-tooth implants replacing maxillary anterior teeth . A secondary objective was to determine peri-implant tissue responses at these implants . MATERIAL S AND METHODS The peri-implant bone and mucosal conditions of 43 implants in 39 subjects were radiographically and clinical ly measured 3 years after implant placement . RESULTS Of the 48 patients originally treated , 39 patients and 43 implants were examined at the 3-year time point . Three of 54 implants failed within the first year . No additional failures were recorded since the 12-month reporting period . Peri-implant bone levels were stable for the 3-year period following implant placement . The change in marginal bone levels after 3 years was 0.42 + /- 0.59 mm . Papilla growth was measured at 1 and 3 years ( 0.61 + /- 0.95 mm and 0.74 + /- 0.79 mm , respectively ) . The buccal peri-implant tissue dimensions at the gingival zenith also increased at 1 and 3 years ( 0.34 + /- 0.94 mm and 0.51 + /- 1.42 mm , respectively ) . No abutment screw loosening or fracture occurred . DISCUSSION AND CONCLUSIONS Early loading of endosseous dental implants placed in healed ridges offers select benefits to clinicians and their patients AIM this study compared the outcome of immediate non-occlusal loading with conventional loading for single implants in the maxillary aesthetic zone . It was hypothesized that immediate non-occlusal loading is not inferior to conventional loading . MATERIAL S AND METHODS sixty-two patients with a missing maxillary anterior tooth were r and omly assigned to be treated with an implant that was either restored with a non-occluding temporary crown within 24 h after implant placement ( the " immediate group " ) or was restored according to a two-stage procedure after 3 months ( the " conventional group " ) . All implants were installed in healed sites . Follow-up visits were conducted after 6 and 18 months post-implant placement . Outcome measures were radiographic marginal bone-level changes , survival , soft tissue aspects ( probing depth , plaque , bleeding , soft tissue level ) , aesthetics and patient 
    Output:
    
CONCLUSIONS Immediately and conventionally loaded single-implant crowns are equally successful regarding implant survival and marginal bone loss .
Immediately and conventionally loaded implants do not appear to differently affect the papilla height during the first year of loading .
Due to the heterogeneity of the time point of baseline measurements and contradictory findings in the studies , it is difficult to draw clear conclusions regarding the recession of the buccal mucosa .