# Peri-Inplant Tissue Stability: A Series of Five Case Reports on an Innovative Implant Design
## 3 Case Description and Results
(**A**) Clinical photo showing the peri-implant tissue adapted surrounding the multiunit abutments; (**B**) radiographical assessment at the immediate loading implant placement and at (**C**) 6 months and (**D**) 36 months. \begin{table}
\begin{tabular}{c} **KM 36** \\ **Months** \\ **(mm)** \\ \end{tabular} \\ \hline
4 & 35 & 0.54 & 1.22 & 1.35 & 4 & 4 \\
4 & 31 & 0.58 & 1.01 & 1.07 & 4 & 4 \\
4 & 33 & 0.84 & 1.45 & 1.6 & 5 & 5 \\
4 & 43 & 0.57 & 1.18 & 1.67 & 4 & 4 \\
4 & 45 & 0.47 & 1.98 & 2.17 & 4 & 4 \\ \hline \multicolumn{2}{c}{Mean} & 0.60 & 1.37 & 1.57 & 4.2 & 4.2 \\ \hline \hline \end{tabular}  
*MBL = marginal bone level; KM = keratinized mucosa.  
\end{table} 
Table 5: Bone level and keratinized mucosa measurements in millimeters (mm). The five treated patients with implant-fixed prostheses recovered without complications or side effects. The patients were monitored closely during follow-ups. The patients did not complain about any pain or swelling. The lack of early or late complications (e.g., wound dehiscence, abscess, or site infection) also demonstrated the presence of healthy peri-implant soft tissues at the constricted areas, protecting the first threads at the implants' constriction. Minimal physiological MBL changes occurred over a one-year follow-up, keeping these minimal changes in cases with more than 1 year of controls, with soft tissue adherence to the smooth part of the most coronal portion of the implant head (Figure 10), indicating an absence of apical migration. The mentioned adherence seemed to configure an important adaptation of the biological width structures, which may have contributed to the biological attachment of the intraosseous portion of the implant. \begin{table}
\begin{tabular}{c c c c c c c} \hline \hline \multirow{2}{*}{**Case No.**} & \multirow{2}{*}{**Tooth No.**} & \multirow{2}{*}{**Initial**} & **MBL 6** & **MBL 12** & **KM 6** & **KM 12** \\  & & & **MBL (mm)** & **Months** & **Months** & **Months** \\  & & & **(mm)** & **(mm)** & **(mm)** & **(mm)** \\ \hline \(5\) & 46 & 1.30 & 1.92 & 2.30 & 4 & 4 \\ \(5\) & 44 & 1.06 & 1.25 & 2.27 & 3 & 3 \\ \(5\) & 42 & 0.63 & 1.09 & 2.29 & 5 & 5 \\ \(5\) & 32 & 0.71 & 1.44 & 1.61 & 4 & 4 \\ \(5\) & 34 & 1.25 & 2.03 & 2.52 & 4 & 4 \\ \(5\) & 36 & 0.86 & 1.24 & 2.48 & 2 & 2 \\ \hline \multicolumn{2}{c}{Mean} & 0.97 & 1.50 & 2.25 & 3.7 & 3.7 \\ \hline \hline \end{tabular}
\end{table} 
Table 6: Bone level and keratinized mucosa measurements in millimeters (mm). Figure 10: Oclusal and buccal view of the peri-implant soft tissue showing a healthy aspect surrounding the multiunit implant component. Figure 9: Mandible full-arch implant-supported rehabilitation with Collo implants. (**A**) Clinical photo showing the peri-implant tissue adapted surrounding the multiunit abutments; (**B**) radiographical assessment at the immediate loading implant placement and at (**C**) 6 months and (**D**) 12 months. The mean and standard deviation values of MBL measurements in the 25 implants analyzed were 0.59 \(\pm\) 0.55 mm at T0, 1.41 \(\pm\) 0.59 mm at T1, and 1.76 \(\pm\) 0.69 mm at T2 (ANOVA \(p\) < 0.0001). Figure 11 shows a graph distribution of the data collected at each time point. The analysis of several factors--such as the evaluation time, gender, and the arch of the implant placement--indicated no statistically significant differences in marginal bone loss (MBL) measurements. This finding underscores the stability of the peri-implant tissues over time, particularly in the coronal region of the implants (see Table 7). All implants in this study were placed at the crestal bone level; however, the variations in the initial measurements (T0) can be attributed to the fact that some implants had been installed in post-extraction sockets, which resulted in irregular bone crests at the time of placement, as depicted in Figure 2.  
The differences in marginal bone loss observed are primarily associated with physiological bone remodeling, a natural response following the placement of implants.