Stable soft tissue and marginal bone maintenance

DENTSPLY Implants sound scienceAchieving beautiful, natural-looking esthetics for your implant patients requires biological sustainability—the harmony of marginal bone and surrounding soft tissue over time.

This harmony exists when all the elements of an implant system—implant design, surface treatment, abutment connection—work in unison with biology.

But biological sustainability is a journey, not only a destination. By searching further and continuing to challenge with sound science, we can provide evidence demonstrating biological sustainability, leading to optimal dental implant treatment outcomes.

Summaries of prospective studies with 5-year data on OsseoSpeed implants with maintained bone levels from implant placement and implant loading confirm stable soft tissue and an average bone reduction of only 0.3 mm.

We search further because we are committed to sound science, providing biological sustainability for a world where everyone can eat, speak and smile with confidence—because it matters.

Biological sustainability

Long-term marginal bone stability

DENTSPLY Implants overall survival rate 98percent

In 1986, a review article was published describing the marginal bone remodeling pattern in dental implant treatment. Data demonstrated that the greatest reduction in marginal bone occurs during the early healing phase and up to the first year in function. Thereafter, marginal bone remodeling stabilizes at approximately -1.5 mm after 5 years—the results became the accepted standard norm for evaluating marginal bone remodeling.* To improve our understanding, we have vigilantly performed systematic literature searches and reviews, following the performance of the ASTRA TECH Implant System with regard to bone maintenance and remodeling.

Numerous studies demonstrate that marginal bone around OsseoSpeed implants is maintained well above the standard norm—even after 5 years in function.**


Marginal bone maintenance with ASTRA TECH Implant System™DENTSPLY Implants Average bone level reduction

ASTRA TECH Implants system bone level graph

Search criteria

  • Prospective studies, published in peer-reviewed journals
  • Full cohort studies (minimum of 10 patients, followed for a minimum of 1 year after loading)
  • Standard protocol (no bone augmentation, no immediate placement in extraction socket)
  • Marginal bone maintenance evaluated from time of implant placement and/or loading

Important findings

  • Data from 17 articles showed an average bone level reduction from implant placement to 5 years of 0.3 mm
  • Data from 62 articles showed an average bone level reduction of 0.3 mm, 1 year after implant loading, remaining stable for 5 years
  • Overall implant survival rate was >98%

Studies were conducted in both educational institutions and private practices, including specialists and general practitioners.


* Standard norm (less than 1 mm bone loss during the first year of loading and less than 0.2 mm annually thereafter, to level out at approximately -1.5 mm after 5 years of loading) according to: Albrektsson T. et al., Int J Oral Maxillofac Implants 1986;1(1):11-25, Albrektsson T. and Zarb GA., Int J Prosthodont 1993;6(2):95-105, Roos J. et al., Int J Oral Maxillofac Implants 1997;12(4):504-514.

** ASTRA TECH Implant System level based on data from 62 articles (published in English, peer-reviewed journals) presenting radiological data on study cohorts of no less than 10 patients receiving standard surgical procedures and followed for minimum 1 year after loading. Literature search September2014.


Improved patient quality of life

Providing your patients with optimal esthetics is a critical factor of successful dental implant therapy and key to their satisfaction and improved quality of life. Studies measuring esthetics and satisfaction metrics demonstrate improved results with OsseoSpeed implants.

  • Stable periimplant soft tissue up to 5 years after implant placement:
    stable mean gingival zenith scores1–4
    first year from crown placement followed by tissue stabilization. 1, 2, 5
  • Minimal gingival recession in challenging situations at 3-year follow-up:
    stable soft tissue levels in situations with limited bucco-lingual or mesodistal
    space with unchanged mean gingival zenith score3–4
  • Patients treated with OsseoSpeed implants have reported improvements 5
    in overall treatment satisfaction.6–9

Gingival zenith score (mm) over time for implants placed in healed sites1

Gingival zenith score graph   Gingival zenith score



Gingival zenith score is defined as the linear distance from the zenith of the buccal gingival margin to the incisal edge of the crown. A decreased gingival zenith score over time means a gain in gingival tissue. 

Maintained esthetics

Excellent long-term clinical results

Properly maintained marginal bone is critical for supporting adjacent soft tissue. Abundant, healthy bone and soft tissue ensures your ability to provide your patients with ideal esthetics.



 biological sustainability maintained bone level



1. Cooper LF, Reside GJ, Raes F, et al. Immediate provisionalization of dental implants placed in healed alveolar ridges and extraction sockets: a 5-year prospective evaluation. Int J Oral Maxillofac Implants 2014;29(3):709-17.
Abstract in PubMed

2. De Bruyn H, Raes F, Cooper LF, et al. Three-years clinical outcome of immediate provisionalization of single OsseoSpeed implants in extraction sockets and healed ridges. Clin Oral Implants Res 2013;24(2):217-23.
Abstract in PubMed

3. Maiorana C, King P, Quaas S, et al. Clinical and radiographic evaluation of early loaded narrow-diameter implants: 3 years follow-up. Clin Oral Implants Res 2015;26(1):77-82.
Abstract in PubMed

4. Galindo-Moreno P, Nilsson P, King P, et al. Clinical and radiographic evaluation of early loaded narrow diameter implants: 1-year followup. Clin Oral Implants Res 2012;23(5):609-16.
Abstract in PubMed

5. Donati M, La Scala V, Di Raimondo R, et al. Marginal bone preservation in singletooth replacement: a 5-year prospective clinical multi-center study. Clin Implant Dent Relat Res 2013;E-pub July 25.
Abstract in PubMed

6. Raes F, Cosyn J, De Bruyn H. Clinical, aesthetic and patient related outcome of immediately loaded single implants in the anterior maxilla: a prospective study in extraction sockets, healed ridges, and grafted sites. Clin Implant Dent Relat Res 2013;15(6):819-35.
Abstract in PubMed

7. Erkapers M, Ekstrand K, Baer RA, et al. Patient satisfaction following dental implant treatment with immediate loading in the edentulous atrophic maxilla. Int J Oral Maxillofac Implants 2011;26(2):356-64.
Abstract in PubMed

8. Vercruyssen M, van de Wiele G, Teughels W, et al. Implant and patient-centered outcome of guided surgery, a 1-year follow-up. An rct comparing guided surgery with conventional implant placement. J Clin Periodontol 2014;41(12):1154-60.
Abstract in PubMed

9. Slot W, Raghoebar GM, Vissink A, et al. Maxillary overdentures supported by four or six implants in the anterior region: 1-year results from a randomized controlled trial. J Clin Periodontol 2013;40(3):303-10.
Abstract in PubMed

View the scientific review on Marginal bone maintenance and ASTRA TECH Implant System™.