Prospective cohort study to evaluate narrow diameter implants for the restoration of a missing maxillary lateral incisor in patients with a cleft palate: Five-year results.

The maxillary lateral incisor is often congenitally missing in patients with a cleft palate. The congenital cleft presents the practitioner with challenges including quantity and quality of bone, a surgically managed cleft correction, and limited clinical space. The purpose of this investigation was...

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Published in:Journal of Prosthetic Dentistry Vol. 134; no. 5; pp. 1738 - 1748
Main Authors: Knobloch, Lisa A., Larsen, Peter, Gohel, Anita, McGlumphy, Edwin, Messner, Robin, Johnston, William, Saponaro, Paola
Format: research Journal Article
Published: Elsevier B.V. Nov2025
Online Access:View this record in EBSCOhost
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      jtl: Journal of Prosthetic Dentistry
      issn: 00223913
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      dt: Nov2025
      vid: 134
      iid: 5
      pid: 467
      pub: Elsevier B.V.
      place: New York, New York
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        189337368
        189337368
        189337368
        10.1016/j.prosdent.2024.07.048
        189337368
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        atl: Prospective cohort study to evaluate narrow diameter implants for the restoration of a missing maxillary lateral incisor in patients with a cleft palate: Five-year results.
      aug:
        au:
          Knobloch, Lisa A.
          Larsen, Peter
          Gohel, Anita
          McGlumphy, Edwin
          Messner, Robin
          Johnston, William
          Saponaro, Paola
        affil: Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, OH
      sug:
        subj:
          Cleft Palate
          Dental Implants Utilization
          Dental Restoration, Permanent
          Tooth Loss Therapy
          Incisor
          Maxilla
          Treatment Outcomes
          Human
          Prospective Studies
          Comparative Studies
          Descriptive Statistics
          Data Analysis Software
          Analysis of Covariance
          Aesthetics, Dental
          Titanium
          Crowns
          Radiography, Dental
          Prosthodontics
      ab: The maxillary lateral incisor is often congenitally missing in patients with a cleft palate. The congenital cleft presents the practitioner with challenges including quantity and quality of bone, a surgically managed cleft correction, and limited clinical space. The purpose of this investigation was to calculate the 5-year success and survival rate of narrow-diameter implants used to restore a missing lateral incisor in patients with a cleft palate. Fourteen study participants with a cleft palate and a missing maxillary lateral incisor were enrolled based on established criteria. Seventeen narrow-diameter implants (AstraTech OsseoSpeed 3.0S and OsseoSpeed TX 3.5 mm) were placed using a 2-stage protocol and restored with a custom titanium abutment and a cement-retained crown. Clinical and radiographic examinations were performed annually for 5 years. Four probe depth measurements were measured and evaluated using an analysis of covariance (ANCOVA) with Tukey-Kramer multiple comparisons tests. Radiographic marginal bone loss was measured annually using a digital subtraction technique and evaluated with ANCOVA, and the least square mean was derived. The restoration was evaluated using Pink (PES) and White (WES) Esthetic scores. Regarding probing depth measurements, a significant variance was found between the 4 locations (P <.001), and a linear effect of year was also found (P =.005). The multiple comparisons tests showed the mean buccal probe depth was lower compared with the mean at each of the other 3 locations (P ≤.039) from baseline to 5-year follow-up. The least square mean ±standard deviation of the marginal bone loss over the 5-year entire study was 0.55 ±0.088 mm. Regarding prosthesis evaluation, the mean score for PES was 6.15 and 6.63 for the WES with a maximum score of 10. The level for clinical acceptance was set at a total score of 6. To meet the criteria for success over the 5-year period, no more than 2.3 mm of total bone loss was acceptable. The number of implants that met the criteria for success at 5 years was 92%. Regarding survival, the number of implants still in place, functional, and asymptomatic at 5 years was 100%. Based on the findings, the peri-implant soft tissue probe depths exhibited significant change during the 5-year investigation. Regarding esthetic outcomes, single tooth NDI for replacing a lateral incisor in the cleft patient is a clinically acceptable treatment. Narrow-diameter implants may be a reliable treatment for replacing a missing lateral incisor in patients with a cleft at 5-year follow-up with an implant survival rate of 100% and a success rate of 92%.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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