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Donati M, La Scala V et al. Clin Implant Dent Relat Res 2015; 17: 425–434

This was a prospective randomised controlled clinical trial over 5 years, when 151 subjects received a single-tooth implant (10 patients received two implants) to replace a missing unit in the aesthetic zone. Implants were placed using combinations of different methods and loading protocols. Assuming all the implants survived in those 11 patients who could not be followed-up (one patient deceased), implant survival was 95.6% after 5 years. When considering success, 6% of implants were associated with pocketing ≥6 mm, but 90% of implants had interdental probing depth measurements of only ≤3 mm. Two crowns decemented and the ceramic from another crown fractured. Surprisingly, those implant sites that showed marginal bone loss at 1-year follow-up, showed bone gain at 5 years (p = 0.04). Multilevel regression analysis showed that smoking was not associated with bone loss. One half of the implants showed bone gain (ca. 1.5 mm) and the rest bone loss (ca. 3.5 mm). There were no differences between the treatment modalities.