###### Abstract  
Porous tantalum trabecular metal biomaterial has a similar structure to trabecular bone, and was recently added to titanium dental implants as a surface enhancement. The purpose of this prospective pilot study was to describe 5-year survival results and crestal bone level changes around immediately-provisionalized Trackular Metal Dental Implants. Eligible patients were adults in need of \(\geq\)1 implants in the posterior jaw. A non-occluding single acrylic provisional crown was in place for up to 14 days before final restoration. Clinical evaluations with radiographs were conducted at each follow-up visit (1 month, 3 months, 6 months, and 1 to 5 years). The primary endpoint was implant survival, characterized using the Kaplan-Meier method. The secondary endpoint was changes in crestal bone level, evaluated using a paired \(t\)-test to compare mean crestal bone levels between the baseline, 6-month, and annual follow-up values. In total, 30 patients (37 implants) were treated. Mean patient age was 45.5 years, and 63% were female. There was one implant failure; cumulative survival at 5 years was 97.2%. After the initial bone loss of 0.40 mm in the first 6 months, there were no statistically significant changes in crestal bone level over time up to 5 years of follow-up.  
d 2022 2021 15 January 20221 15 January 2021 18 January 20221  
used in clinical applications for orthopedics for several decades. PTTM has been recently added to titanium dental implants as an enhancement to titanium implant surfaces [2].  
As originally described by [PERSON] et al., using PTTM as an enhancement for dental implants can potentially provide multiple advantages, including rapid endothelial budding, as well as ingrowth and endothelial neovascularization, both of which are critical for promoting new osseous tissue formation [2]. Based on the extensive prior clinical use of PTTM in orthopedics, a titanium alloy dental implant with a PTTM midsection was developed (Trabecular Metal Dental Implant, Zimmer Dental Inc., Carlsbad, CA, USA). The TM dental implant is manufactured from a combination of titanium alloy and trabecular metal and designed for integration into hard tissue through a process of bone opposition to the threaded implant surface and by bone ingrowth into the porous surface. These dental implants are indicated for delayed and immediate restoration.  
There has been limited clinical research on TM dental implants, with a maximum of 1-year follow-up results reported. In 2013, the authors of the current report published the 1 st year results of a 5-year descriptive, pilot study to evaluate TM dental implants which were immediately restored with a provisional restoration and fully loaded within two weeks. Their evaluation showed that during the first year of the study, PTTM-enhanced titanium dental implants had a 97.3% cumulative implant survival rate and appeared to be able to withstand the clinical demands of immediate loading [4]. The authors noted that longer-term follow-up was needed to better evaluate the performance and clinical characteristics of the TM dental implant. The present report describes the 5-year survival results and crestal bone loss associated with immediately-provisionalized and fully loaded (within two weeks) TM dental implants in a descriptive 5-year pilot study.