About this trial
Losing a tooth in the front part of the upper jaw can affect both appearance and the ability to bite and chew. Treatment to replace missing teeth is therefore often required. Such treatment may be burdensome for the individual and can involve substantial costs for both the patient and society. A common treatment option is placement of a titanium screw (dental implant) in the jawbone. After a healing period, the implant is restored with a crown designed to resemble a natural tooth.
Replacement of missing teeth with dental implants in the anterior maxilla can be particularly challenging. Over time, the crown of an implant may appear shorter than the adjacent natural teeth. This occurs because natural teeth may continue to change position throughout adulthood, whereas dental implants remain fixed within the bone. As a result, the implant-supported crown may appear to sink relative to neighboring teeth, a phenomenon referred to as infraposition. The prevalence of infraposition and the factors contributing to its development are not yet fully understood.
The aim of this study is to determine the frequency and extent of infraposition and to identify potential contributing factors in individuals treated with a single implant-supported crown in the anterior maxilla. The study also aims to evaluate the aesthetic outcome after treatment from both the patient and the clinician perspective.
The study hypothesis is that infraposition occurs in a clinically relevant proportion of patients and that certain factors, such as age at implant placement or individual dental characteristics, may increase the likelihood of its occurrence. It is further hypothesized that infraposition of the implant-supported crown may influence aesthetic appearance and that these changes may be perceived differently by patients and dental professionals.
Through longitudinal follow-up and comparison of repeated digital scans, the study seeks to improve understanding of the occurrence of infraposition, its contributing factors, and its potential impact on the aesthetic outcome of implant-supported crowns over time.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
None
Disqualifiers
None
Trial population
The study population consists of adult patients receiving implant-supported prosthodontic treatment at specialist departments of prosthodontics within the Public Dental Health Service in Sweden. Participants are recruited from the Department of Prosthodontics, Public Dental Health Service, Region Västerbotten, Umeå, and from the Department of Prosthodontics, Folktandvården Eastmaninstitutet, Stockholm.
Trial design
Cohort
Other
Treatments tested in this trial
Not listed
Trial groups
Trial outcomes
Primary outcomes
Infraposition
Outcome Measure 1 Title: Frequency of Infraposition of Implant-Supported Single Crowns Description: Proportion of patients with infraposition of an implant-supported single crown relative to adjacent teeth in the anterior maxilla after crown delivery. Unit of Measure: Percentage (%) of patients Outcome Measure 2 Title: Extent of Infraposition of Implant-Supported Single Crowns Description: Displacement of adjacent teeth relative to implant-supported single crown in the anterior maxilla after crown delivery. Unit of Measure: Millimeters (mm) Outcome Measure 3 Title: Correlation between Extent of Infraposition and Contributing Factors Description: Correlation of infraposition extent (mm) with sex, age at implant placement, medical history/medication, facial height, orthodontic treatment, cause of tooth loss, smile line, temporary restoration, implant and restoration characteristics, augmentation procedures, implant position, and occlusion/articulation. Unit of Measure: Millimeters(mm)
Secondary outcomes
Aesthetic evaluation
To evaluate aesthetic outcomes at baseline and follow-up using both subjective and objective evaluation methods. Secondary Outcome Measure 1 Title: Patient-Reported Aesthetic Outcome Description: Patient-reported aesthetic satisfaction with implant-supported single crowns. Unit: VAS (0-100 mm) and ordinal scale (1-4) Tool: Patient questionnaire using a visual analogue scale and a four-level satisfaction scale Secondary Outcome Measure 2 Title: Clinician-Reported Aesthetic Outcome Description: Clinician-reported aesthetic evaluation of implant-supported single crowns. Unit: VAS (0-100 mm) and ordinal scale (1-4) Tool: Clinician assessment using VAS and a four-level ordinal scale Secondary Outcome Measure 3 Title: Objective Aesthetic Outcome (PES and WES) Description: Objective evaluation of peri-implant soft-tissue and crown-related aesthetics of implant-supported single crowns. Unit: PES and WES scores (0-10) Tool: Clinician assessment using PES and WES
Sponsors and contacts
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Region Västerbotten
Lead sponsor
Umeå University
Collaborator