they incorporate the trans - mucosal abutment facing the soft tissues as an integral part of the implant .
the interface between the trans - mucosal component and the implant is generally located in the neighborhood of the alveolar bone level . in an opi
, the fixture immediately pierces the soft tissue 's barrier ( non - submerged fashion ) in a one - stage surgery , whereas a two - piece implant system is submerged under the soft tissues for a waiting period in a two - stage surgery .
thus , with an opi design , manipulation of the peri - implant soft tissue after initial healing can be avoided .
the implant can be provided with a provisional restoration at placement , allowing the mucosal epithelium and connective tissue adhesion to form coronal to the alveolar crest .
the preparable abutment portion of the implant makes it possible to create an individualized profile that follows the contour of the gingival margin without violating the soft tissue seal .
the surgical protocol for the placement of this implant includes both flap and flapless procedures . however
, avoiding the separation of the periosteum from the underlying tissue may result in a better - maintained blood supply to the marginal bone , thus reducing the likelihood of bone resorption .
therefore , decreased postoperative bleeding , less patient discomfort , shorter surgery time , and reduced healing time are reported advantages for the flapless procedure compared with the flap procedure .
we previously reported the effectiveness of the use of a new type of opi ( diamond , bioimplant , milan , italy ) for oral rehabilitation .
moreover , we demonstrated that spiral family implants can be used successfully in the low bone .
since opis are becoming more and more popular and no reports specifically focus on the clinical outcome these fixtures inserted in canine sites , a retrospective study is performed .
the study population comprised patients admitted at the dental clinic , university of chieti , italy for evaluation and implant treatment , by one surgeon as previously reported , subjects were screened according to the following inclusion criteria : controlled oral hygiene and absence of any lesions in the oral cavity .
in addition , the patients had to agree to participate in a post - operative check up .
the exclusion criteria were as follows : bruxists , smoking more than 20 cigarettes / day , consumption of alcohol ( more than 2 glasses of wine per day ) , localized radiation therapy of the oral cavity , antitumor chemotherapy , liver , blood , and kidney diseases , immunosupressed patients , patients taking corticosteroids , pregnant women , patients with inflammatory and autoimmune diseases of the oral cavity .
several variables were investigated : demographic ( age and gender ) , anatomic ( tooth site and distance between implants ) , implant ( length and diameter ) , and prosthetic ( welding procedure ) variables .
the primary predictor was defined as the presence / absence of the implant at the end of the observation period , i.e. , the survival rate ( svr ) , which is the total number of implants still in place at the end of the follow - up period .
it is defined as the implant success rate ( scr ) and is evaluated according to the absence of persisting peri - implant bone resorption greater than 1.5 mm during the first year of loading and 0.2 mm / year in the following years .
pearson chi - square test was used to detect if implant position has an impact both on failures ( i.e. , lost fixtures ) and/or success ( i.e. , crestal bone resorption more than 1.5 mm around the implants ) .
the study population comprised patients admitted at the dental clinic , university of chieti , italy for evaluation and implant treatment , by one surgeon as previously reported , subjects were screened according to the following inclusion criteria : controlled oral hygiene and absence of any lesions in the oral cavity .
in addition , the patients had to agree to participate in a post - operative check up .
the exclusion criteria were as follows : bruxists , smoking more than 20 cigarettes / day , consumption of alcohol ( more than 2 glasses of wine per day ) , localized radiation therapy of the oral cavity , antitumor chemotherapy , liver , blood , and kidney diseases , immunosupressed patients , patients taking corticosteroids , pregnant women , patients with inflammatory and autoimmune diseases of the oral cavity .
several variables were investigated : demographic ( age and gender ) , anatomic ( tooth site and distance between implants ) , implant ( length and diameter ) , and prosthetic ( welding procedure ) variables .
the primary predictor was defined as the presence / absence of the implant at the end of the observation period , i.e. , the survival rate ( svr ) , which is the total number of implants still in place at the end of the follow - up period . the second predictor of outcome was the peri - implant bone resorption .
it is defined as the implant success rate ( scr ) and is evaluated according to the absence of persisting peri - implant bone resorption greater than 1.5 mm during the first year of loading and 0.2 mm / year in the following years .
pearson chi - square test was used to detect if implant position has an impact both on failures ( i.e. , lost fixtures ) and/or success ( i.e. , crestal bone resorption more than 1.5 mm around the implants ) .
pearson chi - square test was used to detect if implant position has an impact both on failures ( i.e. , lost fixtures ) and/or success ( i.e. , crestal bone resorption more than 1.5 mm around the implants ) .
nineteen patients ( 10 females and 9 males ) with a median age of 62 years ( range , 43 - 80 ) were enrolled .
a total of 176 opis ( diamond , bioimplant , milan , italy ) were inserted . among them
five , 20 , and 7 implants had a diameter narrower , equal to , and wider than 4 mm ; respectively [ figure 1 ] .
two , 5 , and 25 fixtures were shorter , equal to , and longer than 13 mm , respectively .
seventeen fixtures were placed in the mandible and 15 in the maxilla ( 15 in females and 17 in males ) .
the mean observation period , patients age , inter - implant distance , and peri - implant bone resorption per implant were 6  5 months ( range , 1 - 24 months ) , 63  11 years ( range , 43 - 80 years ) , 4.4  2.2 mm ( range , 1.7 - 9.4 mm ) , and 0  0.8 mm ( range , 1.5 - 1.8 mm ) , respectively .
pearson chi - square test is used to detect if the implant site had an impact both on failures ( svr , i.e. , lost fixtures ) and/or success ( scr , i.e. , crestal bone resorption more than 1.5 mm around the implants ) .
one - piece implants ( diamond , bioimplant , milan , italy ) inserted in cuspid sites one implant was lost during the post - operative period ( within 3 months ) and none had a peri - implant bone resorption greater than 1.5 mm ; thus , the svr and scr were 96.8% and 100% , respectively .
statistical analysis demonstrated that no studied variable had an impact on the survival ( i.e. , lost implants ) and clinical success ( i.e. , crestal bone resorption ) .
few articles focus on implants inserted in the canine site , but no article stated the use of opis .
sailer , et al . analyzed if customized zirconium abutments exhibit the same survival rates in the canine and posterior regions as titanium abutments .
twenty - two patients with 40 implants in the posterior region were included and the implant sites were randomly assigned to 20 customized zirconium and 20 customized titanium abutments .
all - ceramic ( ac ) and metal - ceramic ( mc ) crowns were fabricated . in all , except two , cases the crowns were cemented on the abutments using resin or glass ionomer cements .
probing pocket depth ( ppd ) , plaque ( pl ) , and bleeding on probing ( bop ) were assessed and compared with the natural teeth ( control ) .
the data were analyzed with student 's unpaired t - test , analysis of variance ( anova ) , and regression analyses .
twenty patients with 19 zirconium and 12 titanium abutments were examined at a mean follow - up period of 12.6  2.7 months .
no difference in ppd , pl , and bop was observed between the two groups .
thus , the authors concluded that at one year , zirconium abutments exhibited the same survival outcome as titanium abutments . in the same year
zembic , et al . tested whether zirconium abutments exhibit the same survival and technical / biological outcome as titanium abutments .
twenty - two patients receiving 40 single - tooth implants in the canine and posterior regions were included .
the implant sites were randomly assigned to 20 zirconium and 20 titanium abutments . ac and
mc crowns were fabricated . at baseline , 6 , 12 , and 36 months , the reconstructions were examined for technical and biological problems .
probing pocket depth ( ppd ) , plaque control record ( pcr ) , and bop were assessed at abutments ( test ) and analogous contralateral teeth ( control ) .
standardized radiographs of the implants were made and the bone level ( bl ) was measured with reference to the implant shoulder on mesial ( mbl ) and distal sides ( dbl ) .
the data were statistically analyzed with mann  whitney rank and student 's unpaired t - tests .
eighteen patients with 18 zirconium and 10 titanium abutments were examined at a mean follow - up of 36 months .
no difference was observed in the biological outcome of zirconium and titanium abutments : ppd , pcr , and bop .
thus , the authors concluded that at 3 years , zirconium and titanium abutments exhibited same survival and technical , biological , and esthetical outcomes . in 2011 , turkyilmaz and shapiro reported a clinical case in which a primary maxillary canine with both mobility and root resorption was replaced with an immediately restored dental implant placed into the fresh extraction socket .
the implant achieved high primary stability , as determined by resonance frequency analysis , and it was immediately restored with a provisional acrylic resin crown with no centric occlusion .
the implant was stable with no periapical radiolucencies , bop , or pathologic probing depth after 1 year .
the peri - implant soft tissue level appeared stable , and the interdental papillae were preserved , contributing to an optimum final esthetic result .
this case supports the use of single implants for the replacement of extracted primary teeth , especially in areas where esthetics is of high priority .
the immediate provisional crown maintained soft tissue contours and papillary height , thus preventing bone resorption around the dental implant due to peri - implantitis bacteria , which could compromise its stability .
statistical analyses demonstrated that no studied variable had an impact on survival ( i.e. , lost implants ) and clinical success ( i.e. , crestal bone resorption ) .
 background : one - piece implants ( opis ) incorporate the trans - mucosal abutment facing the soft tissues as an integral part of the implant . 
 opis are usually welded together and loaded immediately . since no report focuses specifically on opis 
 inserted in cuspid sites , a retrospective study is performed.materials and methods : nineteen patients ( 10 females and 9 males ) with a median age of 62 years ( range , 43 - 80 ) were admitted at the dental clinic , university of chieti ( italy ) , for evaluation and implant treatment , by one surgeon between january and december 2010.results:in our series , the survival rate ( svr ) and success rate ( scr ) were 96.8% and 100% , respectively . 
 statistical analysis demonstrated that no studied variable had an impact on the survival ( i.e. , lost implants ) and clinical success ( i.e. , crestal bone resorption).conclusion : opis are reliable devices for oral rehabilitation in the cuspid sites . 
INTRODUCTION
MATERIALS AND METHODS
Study design/sample
Variables
Data collection
Surgical protocol
Data analysis
RESULTS
DISCUSSION
CONCLUSION