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What is this about?
- A 3-year prospective case series study on fully tapered, platform-switched implants (Straumann® BLX®) is presented.
- Evidence shows high implant survival and success, stable marginal bone levels, and improved esthetic outcomes.
- The relevance of biologically driven implant placement and the one-abutment–one-time protocol in supporting peri-implant tissue stability.
Maintaining peri-implant tissue stability is one of the key objectives in contemporary implant dentistry. Implant therapy is no longer evaluated only by whether an implant remains in function, but also by how well the surrounding hard and soft tissues are preserved over time. Stable marginal bone levels, healthy peri-implant mucosa, adequate keratinized tissue, and harmonious soft tissue contours all contribute to long-term functional and esthetic success.
The recent publication “Three-Year Outcomes of a Fully Tapered Implant With the One-Time Abutment Protocol Placed in Healed Ridges: A Prospective Case Series” by Yago Leira and collaborators provides clinically relevant insights into this topic. The authors evaluated the performance of a fully tapered, deep-thread, platform-switched implant design (Straumann® BLX®) placed according to the one-abutment–one-time protocol in healed posterior ridges.
Fig. 1: Visualization of the one-abutment, one-time treatment concept
Study design and treatment protocol
The study followed 28 patients treated with 28 Straumann® BLX® implants made of Roxolid® and featuring an SLActive® surface. Implants were placed in healed ridges in the posterior maxilla or mandible and restored with single or partial fixed implant-supported restorations. The clinical protocol included subcrestal implant placement followed by the connection of the definitive screw-retained abutment at the time of surgery. This abutment was then left undisturbed throughout healing and restoration, reflecting the biological principle of reducing repeated and unnecessary manipulation of the peri-implant soft tissues.
Excellent clinical, radiographic, and esthetic outcomes at 3 years
After 3 years of follow-up, the study reported highly favorable clinical outcomes. Both implant survival and implant success were 100% for all implants included in the analysis. No complications were observed at the time of implant placement, and the implants demonstrated stable clinical performance throughout the observation period. Radiographic outcomes showed excellent peri-implant bone stability. The authors reported no clinically relevant marginal bone loss over the 3-year follow-up. Mean marginal bone-level change from baseline to 3 years was only 0.06 ± 0.47 mm mesially and 0.08 ± 0.38 mm distally. These findings suggest that, after initial healing and restoration, marginal crestal bone levels remained stable under functional loading conditions. In addition, esthetic outcomes improved significantly during the follow-up period. The Pink Esthetic Score significantly increased from 9.39 ± 1.47 at baseline to 11.57 ± 1.34 after 3 years (p<0.001), reflecting improvements in papilla fill, soft tissue level, and natural color of the peri-implant tissues.
Fig. 2: Main Results of the study
Clinical relevance
Overall, this 3-year case series study provides encouraging evidence for the clinical performance of Straumann® BLX® implants placed according to the one-abutment–one-time protocol in healed ridges. The results suggest that this biologically driven approach can support stable marginal bone levels, maintain peri-implant soft tissue dimensions, and contribute to favorable esthetic outcomes over time.
Key takeaways:
- Long-term implant success depends on tissue stability, not survival alone. Stable bone levels, healthy soft tissues, and harmonious esthetics are essential indicators of successful implant therapy.
- Biologically driven treatment protocols can help protect peri-implant tissues. Careful implant positioning and reduced manipulation of the soft tissue interface may support favorable hard and soft tissue outcomes over time.
- Clinical evidence supports the value of modern implant design and restorative concepts. Fully tapered, platform-switched implants used with a one-abutment–one-time approach may contribute to predictable functional and esthetic results.