Inclusion Criteria:  Patients who have undergone the initial phase followed by implant placement in the posterior region. Implants placed for more than 5 years.  The implant systems selected are:  Tissue Level Implants: Straumann (Straumann Dental Implants System, Switzerland), Bone Level implants: Branemark, 3i Biomet (external and internal connection), Nobel replace and Astra. Patients who did not comply with the maintenance program and who missed more than 30% of appointments.  Exclusion Criteria:  Systemic diseases (uncontrolled diabetes, drugs which may affect bone metabolism). Totally edentulous. Severe periodontitis not stabilized Inappropriate, unavailable or distorted x-rays. Augmented sites. Implants placed at a supra or infraosseous level. Implants placed immediately after extraction.