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. 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. 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

Purpose: This study aimed to compare the clinical and radiographic outcomes of single posterior screw-retained monolithic implant crowns following a digital and conventional workflow and to report on the survival/complication rate after a mean 4-year follow-up. Materials and Methods: Thirty patients with a single posterior tooth missing were rehabilitated with a bone-level implant. After a healing period of ≥3 months, they were subjected to both a digital and conventional workflow to fabricate two screw-retained monolithic implant crowns. The quantitative clinical adjustments to both crowns (intrasubject comparison) and a questionnaire were recorded at try-in. Thereafter, a crown of the digital and conventional workflows was randomly inserted. At the last follow-up, the marginal bone level (MBL), peri-implant health-related parameters (bleeding on probing (BoP), plaque, pocket probing depth (PPD)), and functional implant prosthodontic score (FIPS) were assessed. Furthermore, the implant survival and success rates and technical complications were evaluated. Results: A total of 27 patients were followed for a mean period of 4.23 ± 1.10 years. There was no significant difference between the digital and conventional workflows regarding clinical adjustments and questionnaire outcomes. More than twice as many participants recommended digital (n = 16) compared to conventional impressions (n = 7) to friends. The implant survival and success rate were 100% and 96.3%, respectively. Furthermore, two de-cementations and one fracture of the ti-base abutment occurred. There were no significant differences in BoP, plaque, and PPD metrics between the two groups. The changes in the MBL between implant crown insertion (baseline) and the last follow-up were 0.07 ± 0.19 mm and 0.34 ± 0.62 mm in the digital and conventional groups, respectively (p = 0.195). The mean overall FIPS score was 8.11 ± 1.37 (range: 5–10). Conclusions: The clinical and radiographic outcomes of single screw-retained monolithic implant crowns were similar between both workflows after a mean of 4 years of service. The patients did not clearly prefer an impression technique for their restoration, although they would recommend the digital impression more often to friends. Thus, decision regarding clinical workflows may be based on the patient’s and/or clinician’s preference.

This open, single-cohort, multicenter, prospective study investigated the efficacy of immediately provisionalized tapered conical connection implant for single-tooth restorations in the anterior and premolar regions of the maxilla after 5 years of function. All implants were placed in healed sites and immediately provisionalized. MBLs, soft-tissue parameters, and oral-health impact profile (OHIP) were evaluated at implant insertion, 6, 12, 24, 36, and 60 months. Paired Wilcoxon signed-rank tests and Kaplan–Meier survival analysis was used for statistical and implant survival/success analyses, respectively. Seventy-seven patients (81 implants) completed the 5-year follow-up. The 5-year cumulative survival and success rates were 97.8%, and the mean MBL change from implant insertion to 5 years was − 0.80 ± 1.13 mm. Optimal papilla index scores were observed at 90.1% of sites at 5 years compared with 32.8% of sites at insertion. Pink esthetic score, modified bleeding and plaque indices, and OHIP showed statistically significant improvement at the 5-year follow-up. Immediately provisionalized tapered conical connection implants promote marginal bone stability and excellent esthetic outcomes after 5 years of function. This treatment is a viable option for patients requiring immediately provisionalized single-tooth restorations in the esthetic zone and shows favorable long-term clinical outcomes, including marginal bone stability and excellent esthetics.

Objective To assess the biomechanical effects of different prosthetic/implant configurations and load directions on 3-unit fixed prostheses supported by short dental implants in the posterior mandible using validated 3-D finite element (FE) models. Methods Models represented an atrophic mandible, missing the 2nd premolar, 1st and 2nd molars, and rehabilitated with either two short implants (implant length-IL = 8 mm and 4 mm) supporting a 3-unit dental bridge or three short implants (IL = 8 mm, 6 mm and 4 mm) supporting zirconia prosthesis in splinted or single crowns design. Load simulations were performed in ABAQUS (Dassault Systèmes, France) under axial and oblique (30°) force of 100 N to assess the global stiffness and forces within the implant prosthesis. Local stresses within implant/prosthesis system and strain energy density (SED) within surrounding bone were determined and compared between configurations. Results The global stiffness was around 1.5 times higher in splinted configurations vs. single crowns, whereby off-axis loading lead to a decrease of 39%. Splinted prostheses exhibited a better stress distribution than single crowns. Local stresses were larger and distributed over a larger area under oblique loads compared to axial load direction. The forces on each implant in the 2-implant-splinted configurations increased by 25% compared to splinted crowns on 3 implants. Loading of un-splinted configurations resulted in increased local SED magnitude. Conclusion Splinting of adjacent short implants in posterior mandible by the prosthetic restoration has a profound effect on the magnitude and distribution of the local stress peaks in peri-implant regions. Replacing each missing tooth with an implant is recommended, whenever bone supply and costs permit.

AIM:As oral rehabilitation of tooth agenesis usually begins at a very young age, it is important to plan the therapy in advance in order to prepare the patient for the final treatment after the end of skeletal and dental growth. The diverse patterns of tooth agenesis require interdisciplinary oral rehabilitation adapted to individual factors like patient's age, number of missing teeth, and alveolar-bone development. The aim of the present high volume single-center study was to provide an overview of the management of patients with tooth agenesis, in terms of treatment approaches, associations, and long-term implant survival, over a period of 30 years.METHODS:Descriptive analyses were performed to analyse treatment approaches and and how they reated to severity of agenesis as well as patients' gender and age. Kaplan-Meier survival curves and log-rank-tests were used to investigate implant survival over time.CONCLUSION:Treatment starts usually in childhood or adolescence; orthodontic therapy was the most common treatment. All treatment options showed similar high survival rates. External bone augmentation might be a risk-factor for implant loss.

The Nobel Trefoil concept is an implant-supported, screw-retained treatment concept on three dental implants in the mandible. Like the precursor system Branemark Novum, it enables less time-consuming treatment, fewer appointments, and increased patient comfort. The presented adapted Viennese concept implements the preoperative digital planning, optimizing treatment safety and predictability. However, the surgical procedure is still recommended in sedoanalgesia or general anesthesia. Further, we present a rare case of implant failure and the less invasive reimplantation in the correct planned position. The Nobel Trefoil concept should not replace established treatment options for the mandible, but it represents an alternative less time-consuming and economically reduced treatment option for patients.

GBR (guided bone regeneration) is a standard procedure for building up bony defects in the jaw. In this procedure, resorbable membranes made of bovine and porcine collagen are increasingly being used, which, in addition to many possible advantages, could have the potential disadvantage of a shorter barrier functionality, especially when augmenting large-volume defects. Thus, it is of importance to evaluate the integration behavior and especially the standing time of barrier membranes using specialized methods to predict its respective biocompatibility. This study is intended to establish a new histomorphometrical analysis method to quantify the integration rate of collagen-based barrier membranes. Three commercially available barrier membranes, i.e., non-crosslinked membranes (BioGide® and Jason® membrane), a ribose-crosslinked membrane (Ossix® Plus), and a newly developed collagen–hyaluronic acid-based (Coll-HA) barrier membrane were implanted in the subcutaneous tissue of 48 6–8-week-old Wistar rats. The explants, after three timepoints (10, 30, and 60 days), were processed and prepared into histological sections for histopathological (host tissue response) and histomorphometrical (cellular invasion) analyses. 10 days after implantation, fragmentation was not evident in any of the study groups. The sections of the Coll-HA, Jason® and BioGide® membranes showed a similar mild inflammatory reaction within the surrounding tissue and an initial superficial cell immigration. Only in the Ossix® Plus group very little inflammation and no cell invasion was detected. While the results of the three commercially available membranes remained intact in the further course of the study, only fragments of the Coll-HA membrane were found 30 and 60 days after implantation. Histomorphometrically, it can be described that although initially (at 10 days post-implantation) similar results were found in all study groups, after 30 days post-implantation the cellular penetration depth of the hyaluronic acid-collagen membrane was significantly increased with time (**** p < 0.0001). Similarly, the percentage of cellular invasion per membrane thickness was also significantly higher in the Coll-HA group at all timepoints, compared to the other membranes (**** p < 0.0001). Altogether, these results show that the histomorphometrical analysis of the cellular migration can act as an indicator of integration and duration of barrier functionality. Via this approach, it was possible to semi-quantify the different levels of cellular penetration of GBR membranes that were only qualitatively analyzed through histopathological approaches before. Additionally, the results of the histopathological and histomorphometrical analyses revealed that hyaluronic acid addition to collagen does not lead to a prolonged standing time, but an increased integration of a collagen-based biomaterial. Therefore, it can only partially be used in the dental field for indications that require fast resorbed membranes and a fast cell or tissue influx such as periodontal regeneration processes.

BACKGROUND:Collagen scaffolds are widely used for guided bone or tissue regeneration. Aiming to enhance their regenerative properties, studies have loaded various substances onto these scaffolds. This review aims to provide an overview of existing literature which conducted in vitro, in vivo, and clinical testing of drug-loaded collagen scaffolds and analyze their outcome of promoting oral regeneration.MATERIALS AND METHODS:PubMed, Scopus, and Ovid Medline® were systematically searched for publications from 2005 to 2019. Journal articles assessing the effect of substances on oral hard or soft tissue regeneration, while using collagen carriers, were screened and qualitatively analyzed. Studies were grouped according to their used substance type-biological medical products, pharmaceuticals, and tissue-, cell-, and matrix-derived products.RESULTS:A total of 77 publications, applying 36 different substances, were included. Collagen scaffolds were demonstrating favorable adsorption behavior and release kinetics which could even be modified. BMP-2 was investigated most frequently, showing positive effects on oral tissue regeneration. BMP-9 showed comparable results at lower concentrations. Also, FGF2 enhanced bone and periodontal healing. Antibiotics improved the scaffold's anti-microbial activity and reduced the penetrability for bacteria.CONCLUSION:Growth factors showed promising results for oral tissue regeneration, while other substances were investigated less frequently. Found effects of investigated substances as well as adsorption and release properties of collagen scaffolds should be considered for further investigation.CLINICAL RELEVANCE:Collagen scaffolds are reliable carriers for any of the applied substances. BMP-2, BMP-9, and FGF2 showed enhanced bone and periodontal healing. Antibiotics improved anti-microbial properties of the scaffolds.

OBJECTIVES:To compare clinical performance of a novel resorbable non-cross-linked collagen membrane (CXP) with a reference membrane (non-cross-linked resorbable membrane; BG) for simultaneous implant placement and guided bone regeneration (GBR) at dehisced single implant sites.MATERIALS AND METHODS:Preliminary data from this randomized controlled trial were reported previously; this is the 12-month report. The primary outcome measure was defected height at 6 months post-GBR. Secondary outcomes included implant cumulative survival rate (CSR) and success rate since placement; bone level changes, pink esthetic score (PES), and patient satisfaction since definitive prosthesis delivery; patient quality of life since pretreatment; and the 1-year bleeding index. Non-parametric statistical analyses were performed.RESULTS:Among patients, 24 were treated with CXP and 25 with BG. The 1-year implant CSR and success rate were 100% (n = 42). Bone level change between definitive prosthetic delivery and 1 year was not significantly different between the CXP and BG groups (BG + 0.42 mm, CXP + 0.01 mm). The PES increased from 7.55 to 8.10 for the CXP group and from 6.48 to 7.48 for the BG group; 1-year bleeding indices were 0 (16 CXP, 18 BG) and 1 (4 CXP, 2 BG). Patient quality of life changed from an OHIP-14 score of 6.5 at pretreatment to 1.9 at 1 year. Overall satisfaction (visual analogue score) with function and esthetics was 9.9 and 9.7, respectively. Inter-group differences were not significant for assessed outcomes. No device-related adverse events were reported.CONCLUSIONS:The use of CXP and BG for simultaneous implant placement and GBR at dehisced implant sites similarly reduced defect height and improved secondary measures, indicating non-inferiority.

Background Narrow diameter implants are primarily intended to rehabilitate the lateral maxillary incisors and lateral and central mandibular incisors because these implants can fit in the limited space between the adjacent natural tooth roots while offering an optimized emergence profile of the restorations in highly esthetic locations. However, few studies have addressed how such implants fare in demanding protocols such as immediate provisionalization. Aim/Hypothesis In this interim report, we present the 3-year bone remodeling and esthetic outcome data from an open, prospective, single cohort, multi-center study designed to evaluate the efficacy and safety of NobelActive 3.0 mm implants placed in immediate function. Materials and Methods This study is being conducted by nine centers and enrolled patients in need of one or more implant-supported single crown(s) in the anterior maxilla or mandible. Implants (NobelActive 3.0, Nobel Biocare AB, Göteborg, Sweden) were placed in extraction or healed sites in a 1-stage procedure and subjected to immediate provisionalization provided they met the stability inclusion criteria. Follow-ups are ongoing and will continue up to 5 years. The primary endpoint of this study, marginal bone level change (MBLC), was assessed using paired standardized periapical radiographs. Cumulative survival rate (CSR) and success rate based on van Steenberghe success criteria were calculated using the life table analysis. Soft tissue health was evaluated using the papilla index according to Jemt, modified plaque and bleeding indices according to Mombelli, and the Pink Esthetic Score (PES) according to Furhauser. Results In this study, 77 patients received 91 implants, of which 67 (73.6%) were placed into healed sites and 24 (26.4%) into extraction sockets. 71 patients (82 implants), 73 patients (84 implants) and 71 patients (82 implants) completed the 1, 2, and 3-year visit, respectively. MBLC analysis revealed that after the expected remodeling of −0.43 ± 1.39 mm (n = 73) from implant insertion to 1 year, the marginal bone levels remained stable with MBLC of; 0.08 ± 0.60 mm (n = 71) from 1 to 2 years and; 0.10 ± 0.55 mm (n = 71) from 2 to 3 years. At 3 years, the CSR was 96.7% and the cumulative success rate was 93.3%. Peri-implant soft tissue assessments revealed very good health- at 3 years 87% of implant sites had healthy papilla (score 2 or 3), plaque and bleeding on probing were absent from 70% and 80% of the sites, respectively, and the overall PES was 9.43 ± 2.72. Conclusion and Clinical Implications At 3 years post-insertion, the narrow-diameter variable-thread tapered implant with a conical connection demonstrates stable marginal bone levels, good survival and success rates, and promotes improved peri-implant soft tissue health, suggesting this implant can be used safely and show predictable outcomes in challenging treatment protocols such as immediate provisionalization and immediate placement into post-extractive sites.

Purpose: To evaluate the influence of implant scanbody (ISB) material, position and operator on the accuracy of a confocal microscopy intraoral scanning (IOS) for complete-arch implant impression. Methods: An edentulous maxillary model with 6 internal hexagonal connection analogues was scanned with an extraoral optical scanner to achieve a reference file. Three ISBs made of different materials (polyetheretherketone (Pk), titanium (T) and Pk with a titanium base (Pkt)) were scanned with IOS by 3 operators. The resulting 45 test files were aligned to the reference file with a best fit algorithm. Linear (Delta X, Delta Y and Delta Z-axis) and angular deviations (Delta ANGLE) were assessed. Absolute values of the linear discrepancies were summed up to obtain a global measure of linear absolute error (Delta ASS). Influence of ISB material, position and operator was statistically assessed using the mixed general linear model. Results: At multivariate analysis, when Delta ASS was considered as response variable, it was identified a significant influence of material (p <0.0001) and position (p= 0.0009) while no significant operator effect was detected. When Delta ANGLE was considered as response variable, material and position significantly influenced the expected Delta ANGLE (p =0.0232 and p <0.0001) and no operator effect was identified. Conclusions: The investigated IOS for complete-arch digital impression was influenced by the ISB material with peek reporting the best results on both linear and angular measurements followed by titanium, peek-titanium resulting as the less accurate. Implant angulation affected significantly the linear deviations while implant position the angular deviations. Operator did not show any significant effect on the IOS accuracy. (C) 2019 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

Objectives: Type 2 diabetes mellitus (T2DM) is a systemic disease that also compromises the bone healing capacity. In healthy individuals, surface modifications of dental implants are proven to increase bone response and implant success. The aim of this study was to clarify if the surface modifications also improve osseointegration in a setting with diabetes mellitus. Methods: T2DM was induced in 7 rats by a high-fat diet/low-dose streptozotocin injection. All animals received a hydroxyapatite (HA) implant, a sandblasted and acid-etched (SLA) implant, and a standard machined titanium implant for control in the tibia. After 4 weeks, thin-ground sections were produced, and the volume of new bone formation (nBV/TV) and bone-to-implant contact (nB.I/Im.I) were histomorphometrically analyzed. Results: Both surface modifications led to an increase of osseointegration compared with the machined surface implant in rats with T2DM. nBV/TV was highest in the SLA implants, whereas nB.I/Im. I was highest in the HA group. Regardless of the surface modification, a super-ordinate regional pattern of new bone formation over the length of the implant was observed. Conclusions: Implants with HA coating and SLA surface modifications seem to have the potential to increase osseointegration also in T2DM rats when compared with a conventional machined surface.

OBJECTIVES:The aim of the present study was to give a detailed analysis on eight proposed implant esthetic indices including a total of 48 parameters with respect to validity and reproducibility as well as its correlation to patients' perception of esthetics.MATERIAL AND METHODS:Standardized intraoral photographs of 189 patients with 189 implant-supported crowns and adjacent peri-implant soft tissue in the esthetic zone (central and lateral incisors, canine, first premolar) served as basis for this evaluation. Eight indices (Papilla Index [PI], Pink Esthetic Score [PES], Implant Crown Aesthetic Index [ICAI], Pink and White Esthetic Score [PES/WES], Complex Esthetic Index [CEI], Implant Aesthetic Score [IAS], Subjective Esthetic Score [SES], and Rompen Index) with a total of 48 parameters were selected. Esthetic evaluation was performed twice by five examiners with an interval of 4 weeks between the evaluations.RESULTS:A total of 1,890 evaluations including eight esthetic indices served as basis for the statistical analysis. Among the overall main scores tested for inter-rater reliability, the highest ρ^inter values were computed for CEI, PES, PI, and IAS scores. By contrast, SES and Rompen showed the worst inter-rater reliability, respectively. The highest level of intra-rater reproducibility was noted for PI, PES, and CEI. The lowest level of intra-rater reproducibility showed Rompen, SES, and ICA. The Papilla Index demonstrated the highest level of inter-rater reliability. The remainder of the single variables (n = 46) did not reach the ρ^inter level of 0.6. The single variables PI mesial, PI distal as well as CEI P4 showed the highest ρ^intra with statistical significance higher than 0.8. The lowest agreement was observed among the variables ICA3, WES5, and IASm2. In general, VAS did not show any good correlation to the esthetic indices proposed so far. The influence of esthetic parameters on subjective patient satisfaction was generally low.CONCLUSION:In conclusion, significant differences regarding reliability and validity could be observed in the present comparison of eight esthetic indices. Objective evaluation of the esthetic outcome of implant therapy inherently fails to reflect subjective patient opinion, however, requires consistency of results to enable between-study comparison and meta-analysis.

Purpose: The aim of this meta-analysis was to evaluate different methods for guided bone regeneration using collagen membranes and particulate grafting materials in implant dentistry. Materials and Methods: An electronic database search and hand search were performed for all relevant articles dealing with guided bone regeneration in implant dentistry published between 1980 and 2014. Only randomized clinical trials and prospective controlled studies were included. The primary outcomes of interest were survival rates, membrane exposure rates, bone gain/defect reduction, and vertical bone loss at follow-up. A meta-analysis was performed to determine the effects of presence of membrane cross-linking, timing of implant placement, membrane fixation, and decortication. Results: Twenty studies met the inclusion criteria. Implant survival rates were similar between simultaneous and subsequent implant placement. The membrane exposure rate of cross-linked membranes was approximately 30% higher than that of non-crosslinked membranes. The use of anorganic bovine bone mineral led to sufficient newly regenerated bone and high implant survival rates. Membrane fixation was weakly associated with increased vertical bone gain, and decortication led to higher horizontal bone gain (defect depth). Conclusion: Guided bone regeneration with particulate graft materials and resorbable collagen membranes is an effective technique for lateral alveolar ridge augmentation. Because implant survival rates for simultaneous and subsequent implant placement were similar, simultaneous implant placement is recommended when possible. Additional techniques like membrane fixation and decortication may represent beneficial implications for the practice.

Objectives: Literature regarding congenitally-missing-teeth (CMT) is lacking especially on CMT-patterns. Thus, the aim of this study was to present an in-depth analysis of 843 patients with CMT treated at a single-center over the past thirty years. Design: Age, date-of-birth-year, gender, medical- and family-history,CMT-types, -numbers, -severity, -region, -symmetry, -patterns using the tooth agenesis code (TAC), and -growth types of all clinically and radiographically diagnosed CMT-patients were collected. Age and occurrence of syndromes were used to divide CMT-patients into non-syndromic patients older than nine years (groupl) and syndromic CMT-patients (group2). Groups were compared especially regarding gender and CMT-severity. Results: The average CMT-number per patient was 5.5 (group1, n = 816, 59.9% female) and 15.1 (group2, n = 27, 29.6% female). There were significant less male (40.1% vs. 70.4%, respectively; P = 0.002) as well as significantly less male-oligodontia (44.8% vs. 73.9%, respectively; P = 0.009) in groupl than in group2. Group1 resulted in decreased prevalence of similar CMT-patterns with severity; the most prevalent CMT was the 2nd premolar; there were no significant differences between the right and left side, whereas more CMT affected the maxilla; the majority of patients presented with bilateral-CMT (82.8%); females were more affected by CMT but more males had severer forms; certain single CMT differed by gender, and CMT was related to first-grade relatives. Conclusion: The majority of CMT-patients presented with hypodontia. Furthermore, same CMT-patterns seem more like to be present in patients with milder forms of tooth agenesis. Gender-specific association regarding CMT-number, severity groups, and single CMT were detected.

The aim of this interim analysis of a 5-year prospective multicenter study is to evaluate clinical and radiological performance of immediately provisionalized 3.0-mm-diameter tapered implants.

This multicenter prospective clinical trial investigated immediately provisionalized, anodized, conical connection, tapered implants with platform shifting in maxillary anterior and premolar sites.

Introduction: Sinus floor augmentation is a routinely used surgical technique for increasing the bone height/volume of the atrophic posterior maxilla. Optimal integration of the implanted augmentation material within the newly formed bone will—at least partly—depend on adequate vascularization to ensure sufficient recruitment of osteoblast and osteoclast precursor cells. Methods: The present technical note describes a modification intended to facilitate increased blood inflow into the augmented space. After preparation of the lateral window and elevation of the Schneiderian membrane, the cortical bone of the sinus floor is perforated several times either by using a piezoelectric device or a microsurgical handpiece with the corresponding tip or bur; these perforations should extend into the trabecular bone. Results and Conclusion: The experiences with this modified technique after 12 patients are presented and discussed. It is expected that by means of this relatively simple technique, increased blood and cell inflow into the augmented space is achieved. This may, in turn, enhance new bone formation and improve the integration of the augmentation material.

An implant-supported prosthesis can restore masticatory function to patients with missing teeth. A prerequisite for success is to position the implant inserted within sufficient bone to be stably osseointegrated, whilst also allowing the restoration to meet functional and esthetic needs. Unfortunately, prosthesis-driven implant sites are not always characterized by adequate bone dimensions. Furthermore, following tooth extraction, severe bone resorption often occurs. Though an array of surgical techniques are available for bone augmentation, guided bone regeneration (GBR) is one that can produce both functional and esthetic results reproducibly with high success rates, whether performed prior to or simultaneous with implant placement. Given the relevance of barrier membrane material and its individual properties to the success of GBR and, consequently, implant-supported restorations, we compared the clinical performance of a new resorbable non-crosslinked collagen membrane, creos xenoprotect (CXP), with a reference membrane Bio-Gide (BG), for GBR at dehisced implant sites. Results from a prospective, randomized clinical trial (NCT02373787) on 49 patients receiving simultaneous GBR and implant insertion demonstrated that both collagen membranes result in safe bone augmentation of dehiscence defects. Implant survival rate at reentry surgery, 6 months after implant insertion, was 100%. The new CXP membrane was statistically non-inferior to the reference BG membrane with respect to mean difference in bone defect height between implant insertion and reentry surgery ( p <0.001). Moreover, there was no difference in patient pain or quality of life between the two treatment arms. However, there were trends in improved outcomes, namely higher bone gain and lower membrane exposure rates, when CXP was used compared with BG, though not statistically significant. Together, the study confirms that, even using a simultaneous surgical approach, the CXP collagen membrane supports bone regeneration at dehisced implant sites with few complications. This demonstrates that new barrier membrane materials with improved properties, such as CXP, can provide clinical benefits to patients.