Esthetically driven immediate provisionalization in the anterior zone: 5-year results from a prospective study evaluating 3.0-mm-diameter tapered implants

objectives: evaluate the 5-year safety and efficacy of a narrow-diameter (3.0 mm) implant that was immediately provisionalized with a single crown in the maxillary lateral incisor or mandibular central or lateral incisor area. materials and methods: an open, prospective, single-cohort, multicenter study was conducted, in which narrow-diameter implants were placed in fresh, healed extraction, or congenitally missing sites. all patients were required to meet strict criteria for immediate loading. the primary endpoints were marginal bone levels (MBL) and MBL changes (MBLC) from implant placement to 5-year follow-up. secondary endpoints included cumulative 5-year survival and success rates, soft tissue health, and esthetic parameters. results: a total of 91 implants were placed in 77 patients. the mean MBL remained stable from the 1-year (- 0.79 ± 0.73 mm, n = 75) to 5-year (- 0.74 ± 0.87 mm, n = 65) follow-up. a marginal bone gain of 0.11 ± 0.83 mm was observed from the 1-year to 5-year follow-up. the cumulative 5-year survival rate was 96.5%, and the cumulative 5-year success rate was 93%. the clinical parameters, including the modified plaque index, modified sulcus bleeding index, Jemt's papilla index, and pink esthetic score improved throughout the 5-year study. conclusions: the study demonstrated that narrow-diameter implants represent a safe and predictable treatment option for subjects suitable for immediate loading and with limited bone volume or limited inter-dental space. clinical relevance: narrow-diameter implants with immediate provisionalization can be considered for use to restore missing or damaged teeth with predictable functional and esthetic outcomes. this trial was registered with clinical trials.gov (NCT02184845).