***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 PURPOSE To compare the efficacy of immediate functionally loaded implants placed with a flapless procedure ( test group ) versus implants placed after flap elevation and conventional load-free healing ( control group ) in partially edentulous patients . MATERIAL S AND METHODS Forty patients were r and omized : 20 to the flapless immediately loaded group and 20 to the conventional group . To be immediately loaded , implants had to be inserted with a minimum torque > 45 Ncm . Implants in the immediately loaded group were provided with full acrylic resin temporary restorations the same day . Implants in the conventional group were submerged ( anterior region ) or left unsubmerged ( posterior region ) and were left load-free for 3 months ( m and ibles ) or 4 months ( maxillae ) . Provisional restorations were replaced with definitive single metal-ceramic crowns 1 month postloading . Outcome measures were prosthesis and implant failures , biological and prosthetic complications , postoperative edema , pain , and use of analgesics . Independent sample chi2 tests , Mann-Whitney tests , t tests , and paired t tests were used with a significance level of .05 . RESULTS Fifty-two implants were placed in the flapless group and 56 in the conventionally loaded group . In the flapless group , 1 flap had to be raised to control the direction of the bur and 1 implant did not reach the planned primary stability and was treated as belonging to the conventional group . After 3 years no dropouts or failures occurred . There was no statistically significant difference for complications ; however , patients in the conventional group had significantly more postoperative edema and pain and consumed more analgesics than those in the flapless group . Osstell values were significantly higher at baseline in the flapless group ( P = .033 ) . When comparing baseline data with years 1 , 2 , and 3 within each group , mean Osstell values of the flapless group did not increase , whereas there were statistically significant increases in the Periotest values . CONCLUSIONS Implants can be successfully placed flapless and loaded immediately without compromising success rates ; the procedure decreases treatment time and patient discomfort This paper describes the 5-year results of a comparative study between Astra Tech and Brånemark system implants . The aim was to compare the systems primarily with regard to bone level changes , and also with regard to other variables of interest . Sixty-six patients with edentulous jaws were included in the study . R and omisation schedules were used to allocate the patients to the two implant systems . 184 Astra Tech implants with a titanium-blasted surface and 187 Brånemark implants with a turned surface were used . The implants were inserted with a two-stage technique and the insertion followed the routines for the respective implant system . All patients were provided with full-arch fixed bridges . All patients were followed up with clinical and radiographic examinations from fixture insertion to the 5-year follow-up . The total mean bone level change in the upper jaw between fixture insertion and the 5-year examination was -1.74+/-0.45 mm at the Astra implants and -1.98+/-0.21 at the Brånemark implants . The corresponding values for the lower jaw were -1.06+/-0.19 for Astra and -1.38+/-0.17 for Brånemark . The major postoperative changes of the marginal bone level took place between fixture insertion and baseline . During this period , there was also a different pattern of bone remodelling between the implant systems . Between baseline ( prosthesis connection ) and the 5-year examination , the marginal bone level changes were small , with no difference between the implant systems . The implant stability was examined with the supraconstructions removed . At the 5-year examination , the survival rate for Astra Tech implants was 98.4 % and for the Brånemark implants it was 94.6 % . The difference was not statistically significant BACKGROUND A new generation of ITI implants , including a hollow cylinder , a hollow screw , and a solid screw , was described in 1988 . Currently , the solid screw is the main alternative . PURPOSE The aim of this study was to gain further clinical documentation of ITI solid-screw implants used in the edentulous upper jaw . This is a report 1 year after loading . MATERIAL S AND METHODS Twenty-eight patients with edentulous upper jaws ( mean age , 57 yr ) were supplied with four to eight ITI solid-screw implants in the upper jaw . In total , 167 implants ( 3.3 and 4.1 mm in diameter ) were inserted . The implants were loaded about 7 months postoperatively . All patients were supplied with fixed screw-retained bridges . RESULTS Twelve implants failed : 10 prior to loading and 2 after . Overall implant survival rate was 92.8 % . Three of the five patients with implant loss were smokers .  Signs of peri-implantitis were found in seven patients , affecting 12 implants . Mean marginal bone level at the loading of the implants ( 7 months after insertion ) was situated 4.7 mm from the reference point of the implant . There was no significant change between loading and the 1-year examination . However , at several implants , the bone level at baseline was situated far apical of the reference point , indicating a bone loss before loading . CONCLUSIONS The ITI screw implants , used in the edentulous upper jaw , had a survival rate of 92.8 % . Mean bone loss between loading and the 1-year examination was 0.1 mm . Some implants had a bone level indicating a significant bone loss before loading . Peri-implantitis was found at about 7.2 % of the implants inserted and at 25 % of the failing implants OBJECTIVE The aim was to compare the clinical , aesthetic and radiological outcome of immediately placed implants in sockets with or without periapical pathology 5 years after placement . MATERIAL S AND METHODS Twenty-seven patients were followed 5 years after immediate implant placement ( test-group : 12 patients with periapical pathologies ; control-group : 15 patients without periapical pathology ) .  Clinical ( FMBS , FMPS , CAL , keratinized mucosa ) , aesthetical ( length of clinical crown , Papilla index ) , and radiological ( vertical distance implant shoulder to first bone to implant contact ( IS-BIC ) ) parameters were assessed . Both 95 % confidence intervals , as well as results of statistical tests ( one- sample , two- sample , paired t-test ) were provided . RESULTS After 5 years the implant survival rate was 100 % for all 27 implants . In the test group the width of the keratinized mucosa increased significantly over the observation period ( 0.8 ± 1.0 mm ) . Concerning aesthetic parameters at the 3-month as well as at the 5-year examination no statistically significant difference could be found between the two groups . In the control-group the papilla mesial and distal to the implant increased statistically significant during the observation period by 0.5 ± 0.5 and 0.4 ± 0.6 index score points , respectively . The position of the gingival margin at the implant site and the two neighboring teeth remained stable . At the 5-year visit IS-BIC measured between 1.4 ± 0.5 mm ( mesial , control ) and 1.7 ± 0.7 mm ( distal , test ) , no significant difference could be found between the two groups . Over the observation period no statistically significant change of IS-BIC could be found in the test- as well as in the control-group . None of the examined radiographs revealed any signs of retro grade peri-implantitis . CONCLUSION The replacement of teeth exhibiting periapical pathologies by implants placed immediately after tooth extraction can be a successful treatment modality with no disadvantages in clinical , aesthetical and radiological parameters to immediately placed implants into healthy sockets STATEMENT OF PROBLEM Treatment of tooth loss in the anterior maxilla can involve difficult functional , esthetic , and psychologic problems , especially in young patients with otherwise good dentition . PURPOSE The purpose of this study was to provide a preliminary comparative evaluation of two implants ( ITI and Astra ) in single-tooth restorations . MATERIAL AND METHODS This prospect i ve study of 102 single-tooth replacements with 56 ITI and 46 Astra dental implants was performed in 82 patients at the Finnish Student Health Service Foundation . One Astra implant was lost before loading . The overall survival rate of the implants was 97.8 % for Astra implants and 100 % for the ITI system . After the initial healing period of at least 6 months , the remaining 101 implants ( 56 ITI , 45 Astra ) were free of periimplant infection and revealed no detectable mobility . Radiographs did not reveal signs of periimplant radiolucencies . All 101 implants received single-tooth crowns . RESULTS Periimplant parameters and acceptable implant function were examined and demonstrated satisfactory results with preestablished clinical parameters and radiographs at 1 year . During the observation time the mean marginal bone loss was 0.13 mm with Astra implants and 0.11 mm with ITI implants . Subjectively all patients were satisfied with their single-tooth restorations supported by either ITI or Astra dental implants . CONCLUSION The favorable results of this short-term study support the application of the two implant systems for single-tooth restorations , especially in the anterior region of the maxilla OBJECTIVES The aim of this prospect i ve cohort study was to evaluate the success rate of titanium screw-type implants with the s and blasted and acid-etched ( SLA ) surface loaded early , after 6 weeks of healing . MATERIAL AND METHODS A total of 104 implants were inserted into posterior sites of 51 partially edentulous patients exhibiting bone densities of class I-III . After a healing period of 6 weeks , all implants were functionally loaded with cemented crowns or fixed partial dentures . The patients were recalled at 3 , 12 , 24 , 36 , 48 and 60 months for clinical and radiographic examination . RESULTS One implant failed to integrate during healing , and three implants were lost to follow-up and were considered drop-outs . The remaining 100 implants showed favorable clinical and radiographic findings at the 5-year examination . The peri-implant soft tissues were stable over time ; the mean probing depths and mean attachment levels did not change during the follow-up period . None of the radiographs exhibited signs of continuous peri-implant radiolucency , which confirmed ankylotic stability for all 100 implants . The measurement of the bone crest levels ( DIB values ) indicated stability as well . Based on strict success criteria , all 100 implants were considered successfully integrated , result ing in a 5-year success rate of 99 % . CONCLUSION This prospect i ve study using an early loading protocol with 6 weeks of healing demonstrated that titanium implants with the SLA surface can achieve and maintain successful tissue integration with high predictability for at least 5 years of follow-up in selected patients and sites OBJECTIVE This paper reports on the long-term outcome of implant-supported posterior-zone prostheses in the first 35 consecutive , partially edentulous patients treated in the Im 
    Output:
    
The incidence of esthetic complications decreased in more recent studies compared with older ones , but the incidence of biologic complications was similar .
There was a significant reduction in abutment or screw loosening by implant-supported FDPs .
On the other h and , the total number of technical complications and the incidence of fracture of the veneering material was significantly increased in the newer studies .
The results of the present systematic review demonstrated a positive learning curve in implant dentistry , represented in higher survival rates and lower complication rates reported in more recent clinical studies .
The incidence of esthetic , biologic , and technical complications , however , is still high .