human
***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 To evaluate healing of marginal defects in immediate transmucosal implants  grafted with anorganic bovine bone , and to assess mucosal and radiographic outcomes 3 - 4 years following restoration . MATERIAL AND METHODS Thirty immediate transmucosal implants in maxillary anterior extraction sites of 30 patients r and omly  received BioOss ( N=10 ; BG ) , BioOss and resorbable collagen membrane ( N=10 ; BG+M ) or no graft ( N=10 ; control ) . RESULTS Vertical defect height ( VDH ) reductions of 81.2+/-5 % , 70.5+/-17.4 % and 68.2+/-16.6 % , and horizontal defect depth ( HDD ) reductions of 71.7+/-34.3 % , 81.7+/-33.7 % and 55+/-28.4 % were observed for BG , BG+M and control groups , respectively , with no significant inter-group differences . Horizontal resorption was significantly greater in control group ( 48.3+/-9.5 % ) when compared with BG ( 15.8+/-16.9 % ) and BG+M ( 20+/-21.9 % ) groups ( P=0.000 ) . Ten sites ( 33.3 % ) exhibited recession of the mucosa after 6 months ; eight ( 26.7 % ) had an unsatisfactory esthetic result post-restoration due to recession . Mucosal recession was significantly associated ( P=0.032 ) with buccally positioned implants ( HDD 1.1+/-0.3 mm ) when compared with lingually positioned implants ( HDD 2.3+/-0.6 mm ) . In 19 patients followed for a mean of 4.0+/-0.7 years , marginal mucosa and bone levels remained stable following restoration . CONCLUSION BioOss significantly reduced horizontal resorption of buccal bone . There is a risk of mucosal recession and adverse soft tissue esthetics with immediate implant placement . However , this risk may be reduced by avoiding a buccal position of the implant in the extraction socket BACKGROUND The width of the facial alveolar bone wall is crucial for long-term successful esthetic outcomes of implants immediately placed into extraction sockets . A threshold of 2 mm is recommended to minimize buccal vertical bone resorption . AIM To assess the width of the facial alveolar bone wall using cone-beam computed tomography images ( CBCT ) . MATERIAL AND METHODS Retrospective CBCT images were acquired from a representative sample of Asians using the i-CAT classic system with a 0.4-mm voxel size . At r and om , 200 CBCT images were selected according to predefined criteria . The DICOM file was imported into the i-CAT Vision software . In the panoramic screen , the middle of each tooth was selected , and in the sagittal window , the middle cross section was selected for performing the measurements using a computer . The vertical distance from the alveolar crest ( BC ) - cemento-enamel junction ( CEJ ) was measured . The width of the facial alveolar bone wall was measured at three locations : 1 , 3 , and 5 mm apical to BC . Descriptive statistics , frequency analyses , and multi-level comparisons were performed . RESULTS The sample consisted of 74 men and 126 women ( mean age of 37.2 years ; range 17 - 82 years ) . A total of 3618 teeth were assessed . There was no significant difference between the values of right and left sides , or between genders . However , statistically significant differences were observed between age groups at all levels . The distance from CEJ to BC varied from 0.4 to 4 mm , with an overall tendency to increase with age . The mean width of the facial alveolar bone wall at anterior teeth was 0.9 mm and increased toward posterior regions . Rarely , a width of 2 mm was yielded ( 0.6 - 1.8 % for anterior teeth , 0.7 - 30.8 % for posterior teeth ) . At a 5-mm distance from BC , minimal widths of facial alveolar bone were identified for the anterior teeth . The frequency of dehiscence ranged from 9.9 % to 51.6 % for anterior and 3.1 % to 53.6 % for posterior teeth , respectively . CONCLUSION A thin facial alveolar bone wall was usually present in both jaws . Hence , for most patients , adjunctive bone augmentation may be needed when installing implants in areas of esthetic concern PURPOSE The aim of this study was to compare bone healing and crestal bone changes following immediate ( I m ) versus delayed ( De ) placement of  titanium dental implants with acid-etched surfaces ( Osseotite ) in extraction sockets . MATERIAL S AND METHODS Forty-six patients were r and omly allocated to the I m or De group ( n = 23 per group ) and received 1 implant at the incisor , canine , or premolar region of the maxilla or the m and ible . The implants were placed an average of 10 days following tooth extraction in the I m group and approximately 3 months after extraction in the De group . The widths ( parallel and perpendicular to the implant ) and the depth of marginal bone defects around the implants were measured clinical ly just after placement and 3 months later at the abutment surgery . The crestal bone changes mesially and distally to the implants were evaluated radiographically by linear measurements . RESULTS The survival rates were 91 % in the I m group and 96 % in the De group . In the I m group , the mean reductions in parallel width , perpendicular width , and depth of the largest defect of each implant amounted to 48 % ( from 4.4 to 2.3 mm ) , 59 % ( from 2.2 to 0.9 mm ) , and 48 % ( from 6.9 to 3.6 mm ) , respectively . The corresponding mean reductions in the De group amounted to 39 % ( from 3.1 to 1.9 mm ) , 77 % ( from 1.3 to 0.3 mm ) , and 34 % ( from 4.4 to 2.9 mm ) . The reduction over time was statistically significant in both groups ( P < .04 ) . For both groups , a higher degree of bone healing was achieved in the infrabony defects ( > 60 % for depth ) than in dehiscence-type defects ( approximately 25 % ) . Furthermore , 70 % of the 3-wall infrabony defects with a parallel width of up to 5 mm , a depth of maximum 4 mm , and a perpendicular width of maximum 2 mm had a capacity of spontaneous healing within a period of 3 months . DISCUSSION AND CONCLUSION New bone formation occurs in infrabony defects associated with immediately placed implants in extraction sockets Twenty-one  c.p . titanium screw-shaped implants were immediately installed after extraction and thorough curettage of the alveoli in 15 patients .  Granules of deproteinized bovine bone of 0.25 - 1.0 mm diameter were used to fill the remaining defect when the distance of the defect wall to the implant surface was > 3 mm . Dimensional measurements of the defect height and width were made with a pocket probe . Fourteen sites in the upper jaw and 7 sites in the lower jaw were thus treated . The mean defect depth varied between 7 mm vestibularly and 10 mm mesially . The mucoperiosteal flaps were hermetically closed . At re-entry , the particles were packed and firmly attached but still distinguishable from the surrounding bone . Of the 21 sites treated , 5 sites had an exposure of the implant cover screw during the healing period . An exposure of the granular material occurred in 4 sites , but loss of granules in only 3 . Even in these sites no signs of infection or inflammation of the soft tissues were observed . At re-entry after 6 months , 10 sites were completely and 9 partially filled . For the partial fills , the mean remaining defect height was 1.6 mm ( range : 0.6 - 3.0 mm ) . Two sites showed an increased defect of respectively 2.4 and 4.8 mm . No fixtures were lost . The present results indicate that deproteinized bovine bone is a safe filling material to fill remaining defects around implants installed in fresh extraction sockets PURPOSE This 1-year prospect i ve study evaluated the implant success rate , peri-implant tissue response , and esthetic outcome of immediately placed and provisionalized maxillary anterior single implants .  MATERIAL S AND METHODS Thirty-five patients ( 8 men , 27 women ) with a mean age of 36.5 years ( range 18 to 65 ) were included in this study .  Thirty-five threaded , hydroxyapatite-coated implants were placed and provisionalized immediately after each failing tooth had been removed . The definitive restoration was placed 6 months later . The patients were evaluated clinical ly and radiographically at implant placement and at 3 , 6 , and 12 months after implant placement . RESULTS At 12 months , all implants remained osseointegrated . The mean marginal bone change from the time of implant placement to 12 months was -0.26 + /- 0.40 mm mesially and -0.22 + /- 0.28 mm distally . No significant differences in the Plaque Index scores were noted at different time intervals . The mean midfacial gingival level and mesial and distal papilla level changes from pretreatment to 12 months were -0.55 + /- 0.53 mm , -0.53 + /- 0.39 mm , and -0.39 + /- 0.40 mm , respectively . All patients were very satisfied with the esthetic outcome and none had noticed any changes at the gingival level . DISCUSSION Although marginal bone and gingival level changes were statistically significant from pretreatment to 12 months of follow-up , they were well within clinical expectations . CONCLUSION The results of this study suggest that favorable implant success rates , peri-implant tissue responses , and esthetic outcomes can be achieved with immediately placed and provisionalized maxillary anterior single implants The aim of the present clinical study was to evaluate the placement of transmucosal implants into fresh extraction sockets and their immediate restoration with temporary crowns . A series of 22 cases with a 12-month follow-up is presented . Twenty-two patients ( 15 women and 7 men ; mean age 39 years ) who needed a single tooth replaced because of vertical or horizontal root fracture , caries , endodontic lesions , or periodontal disease were treated with immediate post extraction implant placement .  The implant was then restored with a screw-retained prosthetic restoration within 24 hours . Radiographic assessment s were made at baseline and 12 months after implant placement . Clinical parameters , such as plaque score , mucositis score , probing attachment level , mucosal margin position , variation of gingival level , and variation of papilla position , were also measured at baseline and after 12 months of follow-up . At 12 months , no implants had failed . Radiographic examination revealed mean bone resorption of 0.5 mm at 12 months compared to baseline . The mean variation of gingival level , compared to the neighboring teeth , was -0.75 mm . Probing attachment levels were 0.79 , 0.45 , and 0.54 mm at proximal , buccal , and lingual sites , respectively . The values for the mucosal margin position were 2.9 , 2.2 , and 2.4 mm at proximal , buccal , and lingual sites , respectively . Regarding variation of papilla position , according to Jemt 's index , 27 papillae presented with a score of 2 ( 61 % ) and 17 with a score of 3 ( 39 % ) . An examination of oral hygiene and peri-implant soft tissue conditions at the 12-month follow-up visit revealed an overall frequency of plaque-carrying implant surfaces of 13 % . Furthermore , mucositis ( score 2 ) was not observed at any of the peri-implant units . Primary implant stability did not significantly increase over time . The immediate restoration of dental implants placed into fresh extraction sockets was shown to be a safe and predictable procedure . The success rate and radiographic and clinical results were comparable to those obtained following the st and ard protocol . Within the limits of the present investigation , immediate restoration of single-tooth implants placed in fresh extraction sockets can be considered a valuable option to replace a missing tooth . However , long-term clinical trials are needed to confirm the present results BACKGROUND Single-rooted teeth deemed not restorable via conventional means may be c and i date s for implant placement at the time of tooth extraction .  Immediate implant placements are believed to preserve soft and hard tissue form and contours , reduce the need for augmentation procedures , minimize surgical exposure of the patient , reduce treatment time and improve esthetic outcomes . METHOD This retrospective review analyzed the  esthetic outcomes of 42 non-adjacent single-unit implant restorations completed using an immediate implant surgical placement protocol .  RESULTS The mean time in function was 18.9 months ( range 6 - 50 months ) and the majority of implants placed had a restorative platform diameter of 4.1 and 4.8 mm . A highly significant change in crown height due to marginal tissue recession of 0.9 + /- 0.78 mm ( P=0.000 ) was recorded for all sites , with no difference seen between implant systems ( P=0.837 ) . Thin tissue biotype showed slightly greater recession than thick tissue biotype ( 1 + /- 0.9 vs. 0 
    Output:
    
agent
Conclusion It can be concluded that bone remodeling occurs after tooth extraction and immediate implant installation
***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 To evaluate healing of marginal defects in immediate transmucosal implants  grafted with anorganic bovine bone , and to assess mucosal and radiographic outcomes 3 - 4 years following restoration . MATERIAL AND METHODS Thirty immediate transmucosal implants in maxillary anterior extraction sites of 30 patients r and omly  received BioOss ( N=10 ; BG ) , BioOss and resorbable collagen membrane ( N=10 ; BG+M ) or no graft ( N=10 ; control ) . RESULTS Vertical defect height ( VDH ) reductions of 81.2+/-5 % , 70.5+/-17.4 % and 68.2+/-16.6 % , and horizontal defect depth ( HDD ) reductions of 71.7+/-34.3 % , 81.7+/-33.7 % and 55+/-28.4 % were observed for BG , BG+M and control groups , respectively , with no significant inter-group differences . Horizontal resorption was significantly greater in control group ( 48.3+/-9.5 % ) when compared with BG ( 15.8+/-16.9 % ) and BG+M ( 20+/-21.9 % ) groups ( P=0.000 ) . Ten sites ( 33.3 % ) exhibited recession of the mucosa after 6 months ; eight ( 26.7 % ) had an unsatisfactory esthetic result post-restoration due to recession . Mucosal recession was significantly associated ( P=0.032 ) with buccally positioned implants ( HDD 1.1+/-0.3 mm ) when compared with lingually positioned implants ( HDD 2.3+/-0.6 mm ) . In 19 patients followed for a mean of 4.0+/-0.7 years , marginal mucosa and bone levels remained stable following restoration . CONCLUSION BioOss significantly reduced horizontal resorption of buccal bone . There is a risk of mucosal recession and adverse soft tissue esthetics with immediate implant placement . However , this risk may be reduced by avoiding a buccal position of the implant in the extraction socket BACKGROUND The width of the facial alveolar bone wall is crucial for long-term successful esthetic outcomes of implants immediately placed into extraction sockets . A threshold of 2 mm is recommended to minimize buccal vertical bone resorption . AIM To assess the width of the facial alveolar bone wall using cone-beam computed tomography images ( CBCT ) . MATERIAL AND METHODS Retrospective CBCT images were acquired from a representative sample of Asians using the i-CAT classic system with a 0.4-mm voxel size . At r and om , 200 CBCT images were selected according to predefined criteria . The DICOM file was imported into the i-CAT Vision software . In the panoramic screen , the middle of each tooth was selected , and in the sagittal window , the middle cross section was selected for performing the measurements using a computer . The vertical distance from the alveolar crest ( BC ) - cemento-enamel junction ( CEJ ) was measured . The width of the facial alveolar bone wall was measured at three locations : 1 , 3 , and 5 mm apical to BC . Descriptive statistics , frequency analyses , and multi-level comparisons were performed . RESULTS The sample consisted of 74 men and 126 women ( mean age of 37.2 years ; range 17 - 82 years ) . A total of 3618 teeth were assessed . There was no significant difference between the values of right and left sides , or between genders . However , statistically significant differences were observed between age groups at all levels . The distance from CEJ to BC varied from 0.4 to 4 mm , with an overall tendency to increase with age . The mean width of the facial alveolar bone wall at anterior teeth was 0.9 mm and increased toward posterior regions . Rarely , a width of 2 mm was yielded ( 0.6 - 1.8 % for anterior teeth , 0.7 - 30.8 % for posterior teeth ) . At a 5-mm distance from BC , minimal widths of facial alveolar bone were identified for the anterior teeth . The frequency of dehiscence ranged from 9.9 % to 51.6 % for anterior and 3.1 % to 53.6 % for posterior teeth , respectively . CONCLUSION A thin facial alveolar bone wall was usually present in both jaws . Hence , for most patients , adjunctive bone augmentation may be needed when installing implants in areas of esthetic concern PURPOSE The aim of this study was to compare bone healing and crestal bone changes following immediate ( I m ) versus delayed ( De ) placement of  titanium dental implants with acid-etched surfaces ( Osseotite ) in extraction sockets . MATERIAL S AND METHODS Forty-six patients were r and omly allocated to the I m or De group ( n = 23 per group ) and received 1 implant at the incisor , canine , or premolar region of the maxilla or the m and ible . The implants were placed an average of 10 days following tooth extraction in the I m group and approximately 3 months after extraction in the De group . The widths ( parallel and perpendicular to the implant ) and the depth of marginal bone defects around the implants were measured clinical ly just after placement and 3 months later at the abutment surgery . The crestal bone changes mesially and distally to the implants were evaluated radiographically by linear measurements . RESULTS The survival rates were 91 % in the I m group and 96 % in the De group . In the I m group , the mean reductions in parallel width , perpendicular width , and depth of the largest defect of each implant amounted to 48 % ( from 4.4 to 2.3 mm ) , 59 % ( from 2.2 to 0.9 mm ) , and 48 % ( from 6.9 to 3.6 mm ) , respectively . The corresponding mean reductions in the De group amounted to 39 % ( from 3.1 to 1.9 mm ) , 77 % ( from 1.3 to 0.3 mm ) , and 34 % ( from 4.4 to 2.9 mm ) . The reduction over time was statistically significant in both groups ( P < .04 ) . For both groups , a higher degree of bone healing was achieved in the infrabony defects ( > 60 % for depth ) than in dehiscence-type defects ( approximately 25 % ) . Furthermore , 70 % of the 3-wall infrabony defects with a parallel width of up to 5 mm , a depth of maximum 4 mm , and a perpendicular width of maximum 2 mm had a capacity of spontaneous healing within a period of 3 months . DISCUSSION AND CONCLUSION New bone formation occurs in infrabony defects associated with immediately placed implants in extraction sockets Twenty-one  c.p . titanium screw-shaped implants were immediately installed after extraction and thorough curettage of the alveoli in 15 patients .  Granules of deproteinized bovine bone of 0.25 - 1.0 mm diameter were used to fill the remaining defect when the distance of the defect wall to the implant surface was > 3 mm . Dimensional measurements of the defect height and width were made with a pocket probe . Fourteen sites in the upper jaw and 7 sites in the lower jaw were thus treated . The mean defect depth varied between 7 mm vestibularly and 10 mm mesially . The mucoperiosteal flaps were hermetically closed . At re-entry , the particles were packed and firmly attached but still distinguishable from the surrounding bone . Of the 21 sites treated , 5 sites had an exposure of the implant cover screw during the healing period . An exposure of the granular material occurred in 4 sites , but loss of granules in only 3 . Even in these sites no signs of infection or inflammation of the soft tissues were observed . At re-entry after 6 months , 10 sites were completely and 9 partially filled . For the partial fills , the mean remaining defect height was 1.6 mm ( range : 0.6 - 3.0 mm ) . Two sites showed an increased defect of respectively 2.4 and 4.8 mm . No fixtures were lost . The present results indicate that deproteinized bovine bone is a safe filling material to fill remaining defects around implants installed in fresh extraction sockets PURPOSE This 1-year prospect i ve study evaluated the implant success rate , peri-implant tissue response , and esthetic outcome of immediately placed and provisionalized maxillary anterior single implants .  MATERIAL S AND METHODS Thirty-five patients ( 8 men , 27 women ) with a mean age of 36.5 years ( range 18 to 65 ) were included in this study .  Thirty-five threaded , hydroxyapatite-coated implants were placed and provisionalized immediately after each failing tooth had been removed . The definitive restoration was placed 6 months later . The patients were evaluated clinical ly and radiographically at implant placement and at 3 , 6 , and 12 months after implant placement . RESULTS At 12 months , all implants remained osseointegrated . The mean marginal bone change from the time of implant placement to 12 months was -0.26 + /- 0.40 mm mesially and -0.22 + /- 0.28 mm distally . No significant differences in the Plaque Index scores were noted at different time intervals . The mean midfacial gingival level and mesial and distal papilla level changes from pretreatment to 12 months were -0.55 + /- 0.53 mm , -0.53 + /- 0.39 mm , and -0.39 + /- 0.40 mm , respectively . All patients were very satisfied with the esthetic outcome and none had noticed any changes at the gingival level . DISCUSSION Although marginal bone and gingival level changes were statistically significant from pretreatment to 12 months of follow-up , they were well within clinical expectations . CONCLUSION The results of this study suggest that favorable implant success rates , peri-implant tissue responses , and esthetic outcomes can be achieved with immediately placed and provisionalized maxillary anterior single implants The aim of the present clinical study was to evaluate the placement of transmucosal implants into fresh extraction sockets and their immediate restoration with temporary crowns . A series of 22 cases with a 12-month follow-up is presented . Twenty-two patients ( 15 women and 7 men ; mean age 39 years ) who needed a single tooth replaced because of vertical or horizontal root fracture , caries , endodontic lesions , or periodontal disease were treated with immediate post extraction implant placement .  The implant was then restored with a screw-retained prosthetic restoration within 24 hours . Radiographic assessment s were made at baseline and 12 months after implant placement . Clinical parameters , such as plaque score , mucositis score , probing attachment level , mucosal margin position , variation of gingival level , and variation of papilla position , were also measured at baseline and after 12 months of follow-up . At 12 months , no implants had failed . Radiographic examination revealed mean bone resorption of 0.5 mm at 12 months compared to baseline . The mean variation of gingival level , compared to the neighboring teeth , was -0.75 mm . Probing attachment levels were 0.79 , 0.45 , and 0.54 mm at proximal , buccal , and lingual sites , respectively . The values for the mucosal margin position were 2.9 , 2.2 , and 2.4 mm at proximal , buccal , and lingual sites , respectively . Regarding variation of papilla position , according to Jemt 's index , 27 papillae presented with a score of 2 ( 61 % ) and 17 with a score of 3 ( 39 % ) . An examination of oral hygiene and peri-implant soft tissue conditions at the 12-month follow-up visit revealed an overall frequency of plaque-carrying implant surfaces of 13 % . Furthermore , mucositis ( score 2 ) was not observed at any of the peri-implant units . Primary implant stability did not significantly increase over time . The immediate restoration of dental implants placed into fresh extraction sockets was shown to be a safe and predictable procedure . The success rate and radiographic and clinical results were comparable to those obtained following the st and ard protocol . Within the limits of the present investigation , immediate restoration of single-tooth implants placed in fresh extraction sockets can be considered a valuable option to replace a missing tooth . However , long-term clinical trials are needed to confirm the present results BACKGROUND Single-rooted teeth deemed not restorable via conventional means may be c and i date s for implant placement at the time of tooth extraction .  Immediate implant placements are believed to preserve soft and hard tissue form and contours , reduce the need for augmentation procedures , minimize surgical exposure of the patient , reduce treatment time and improve esthetic outcomes . METHOD This retrospective review analyzed the  esthetic outcomes of 42 non-adjacent single-unit implant restorations completed using an immediate implant surgical placement protocol .  RESULTS The mean time in function was 18.9 months ( range 6 - 50 months ) and the majority of implants placed had a restorative platform diameter of 4.1 and 4.8 mm . A highly significant change in crown height due to marginal tissue recession of 0.9 + /- 0.78 mm ( P=0.000 ) was recorded for all sites , with no difference seen between implant systems ( P=0.837 ) . Thin tissue biotype showed slightly greater recession than thick tissue biotype ( 1 + /- 0.9 vs. 0 
    Output:
    