The distally anchored connective tissue graft platform for papilla enhancement: A case report.

BACKGROUND: As the need for using dental implants to replace single missing teeth grows, so does the demand for greater esthetic results. However, achieving complete interproximal papillae fill in single-tooth implant restorations remains a challenge. The distally anchored connective tissue platform is a novel soft tissue augmentation technique that consists of harvesting an autogenous connective tissue graft from the palate, folding it, and positioning it at the level of the distal occlusal and buccal surfaces with the help of a distal sling suture to the adjacent distal tooth. METHODS: This case report describes how a maxillary central incisor with compromised hard and soft tissues were replaced using a comprehensive treatment plan. RESULTS: The clinical outcomes showed stable mucosal margin levels and complete papillae fill. The patient expressed satisfaction with the achieved results. CONCLUSIONS: The distally anchored connective tissue graft platform performed at the time of implant placement emerges as a viable and effective soft tissue augmentation technique that yields highly esthetic results. KEY POINTS: Why is this case new information? To the best of our knowledge, this is the first case report in the literature using the distally anchored connective tissue platform. What are the keys to successful management of this case? Adequate diagnosis and decision-making, resulting in a treatment plan focused on reconstructing both soft and hard tissues in a single-tooth implant within the esthetic area, yield favorable clinical, radiological, and patient-reported outcomes. What are the primary limitations to success in this case? The primary limitation of this study is its reliance on a single case report.

Graftless Immediate Dual Implant Anatomic Placement With Immediate Provisional Passive Loading and Definitive Hybrid Crown for the Restoration of Mandibular Molar: A Clinical Report.

Immediate implant placement is well-known science and treatment in implant dentistry. It is a multitasking treatment consisting of surgical, prosthodontic, and periodontal aspects, implemented to obtain long-term clinically esthetic and functioning prosthesis. Immediate placement enables clinicians to reduce the number of surgical steps and shorter treatment duration. It has become a standard surgical protocol in modern implant practice. According to existing literature, dual implant placement can be done to avoid any cantilever effect in a single implant and to distribute masticatory forces. This clinical report describes the extraction of an infected mandibular right first molar, (46, Federation Dentaire Internationale) followed by immediate dual placement of dental implants in the rinsed and cleansed sockets. The tooth was atraumatically extracted from the socket, and the latter was prepared to the required depth, and endosseous implants were placed in both the mesial and distal sockets. This atraumatic graft-free operating technique and immediate placement resulted in the preservation of hard and soft tissues. It also increased the patient's comfort, acceptance, and satisfaction due to immediate loading with a provisional removable prosthesis. This was later replaced with a dual screw-retained hybrid implant crown.

Biomechanical Behavior of Narrow Dental Implants Made with Aluminum- and Vanadium-Free Alloys: A Finite Element Analysis.

Titanium (Ti) alloys used for narrow dental implants usually contain aluminum (Al) and vanadium (V) for improved resistance. However, those elements are linked to possible cytotoxic effects. Thus, this study evaluated the biomechanical behavior of narrow dental implants made with Al- and V-free Ti alloys by the finite element method. A virtual model of a partially edentulous maxilla received single implants (diameter: 2.7 and 2.9 mm; length: 10 mm) at the upper lateral incisor area, with respective abutments and porcelain-fused-to-metal crowns. Simulations were performed for each implant diameter and the following eight alloys (and elastic moduli): (1) Ti-6Al-4V (control; 110 GPa), (2) Ti-35Nb-5Sn-6Mo-3Zr (85 GPa), (3) Ti-13Nb-13Zr (77 GPa), (4) Ti-15Zr (113 GPa), (5) Ti-8Fe-5Ta (120 GPa), (6) Ti-26.88Fe-4Ta (175 GPa), (7) TNTZ-2Fe-0.4O (107 GPa), and (8) TNTZ-2Fe-0.7O (109 GPa). The implants received a labially directed total static load of 100 N at a 45° angle relative to their long axis. Parameters for analysis included the maximum and minimum principal stresses for bone, and von Mises equivalent stress for implants and abutments. Ti-26.88Fe-4Ta reaches the lowest maximum (57 MPa) and minimum (125 MPa) principal stress values, whereas Ti-35Nb-5Sn-6Mo-3Zr (183 MPa) and Ti-13Nb-13Zr (191 MPa) models result in the highest principal stresses (the 2.7 mm model surpasses the threshold for bone overload). Implant diameters affect von Mises stresses more than the constituent alloys. It can be concluded that the narrow implants made of the Ti-26.88Fe-4Ta alloy have the most favorable biomechanical behavior, mostly by mitigating stress on peri-implant bone.

Long-term results of immediate implantation in mandibular posterior teeth with early loading: A retrospective case series.

When immediate molar implants first were proposed, submerged initial healing and delayed loading were the norm. It is now recognized that some early loading of a nonocclusal nature can stimulate faster osseointegration, although full occlusal loading is still delayed for 3 or more months. Here, we test the hypothesis that earlier occlusal loading of mandibular premolar and molar immediate implants may be possible. In this retrospective case series study, 18 mandibular molar and nine mandibular premolar teeth were atraumatically extracted and immediate implants placed 1-2 mm apical to buccal and lingual crestal bone. Periimplant gaps received particular allograft covered with acellular dermal matrix barrier. Healing abutments were placed through puncture points in the membranes to help in stabilizing the latter and to permit nonsubmerged site healing. At 6-8 weeks, each implant was evaluated for stability using the Periotest® device and restored if the Periotest® (PTV) value seen was negative. Data were analyzed by t test and MannWhitney U at a significance level of P < 0.05. Retrospective assessment of all 27 implants after 5 years' period of follow up showed all implants to have survived. Overall mean crestal bone loss was determined to be-0.25 ± 0.54 mm. Individual mean bone levels for mesial and distal surfaces were-0.24 ± 0.77 mm and-0.26 ± 0.72 mm, respectively (P = 0.78). A statistically significant difference in bone loss between genders was detected. Overall mean probing depth was 2.09 ± 0.57 mm. Based on the widely used Albrektsson criteria, the overall survival and success rate was 100%. Immediate implants placed into mandibular premolar and molar extraction sockets and allowed nonsubmerged healing may be ready for restoration at earlier times than previously thought possible.

Probing single-tooth dental implants with and without prostheses: a cross-sectional study comparing healthy and peri-implant mucositis sites.

AIM: To evaluate differences in probing depth (PPD) with and without a prosthesis in implants without interproximal bone loss (IBL). Secondarily, to assess whether the difference in PPD measured with and without the crown was affected by diagnosis or implant location. MATERIALS AND METHODS: A cross-sectional study was conducted in patients with a single screw-retained implant-supported crown in the posterior area, without IBL. PPD and was assessed before and after crown removal. A subgroup analysis compared healthy vs. mucositis implants and premolar vs. molar locations. RESULTS: In the 62 implants analysed (23 healthy and 39 with mucositis), the PPD was 1.15 mm (SD = 1.24 mm) deeper without the prosthesis than with it (p < .001). This difference was independent of the implant location (p > .05) except for buccal sites (p = .048). The mean PPD difference for implants with mucositis was 0.95 mm (SD = 1.19 mm; p < .001) while healthy implants had a mean PPD variation of 1.47 mm (SD = 1.29 mm; p < .001). CONCLUSION: The presence of prosthesis in single-tooth implants in the posterior area without IBL seems to lead to an underestimation of PPD that appears to be significant in implants diagnosed with mucositis, although the difference is even greater in healthy implants. Further studies are needed to confirm these findings.

Finite element analysis of narrow dental implants.

Narrow-diameter implants (NDIs) traditionally have been associated to higher rates of failure in comparison with regular-diameter implants (RDIs) and wide-diameter implants (WDIs), since they generate a more unfavorable stress distribution in peri-implant bone. However, it is well known that the load sharing effect associated with prostheses supported by multiple implants (also called splinted prostheses) affords mechanical benefits. The present study involves finite element analysis (FEA) to determine whether the risks linked to NDIs could be mitigated by the mechanical advantages afforded by the splinting concept. For this purpose, a three-dimensional (3D) model of a real maxilla was reconstructed from computed tomography (CT) images, and different implants (NDIs, RDIs and WDIs) and prostheses were created using computer-aided design (CAD) tools. Biting forces were simulated on the prostheses corresponding to three different rehabilitation solutions: single-implant restoration, three-unit bridge and all-on-four treatment. Stress distribution around the implants was calculated, and overloading in bone was quantified within peri-implant volumes enclosed by cylinders with a diameter 0.1mm greater than that of each implant. The mechanical benefits of the splinting concept were confirmed: the peri-implant overloaded volume around NDIs splinted by means of the three-unit bridge was significantly reduced in comparison with the nonsplinted condition and, most importantly, proved even smaller than that around nonsplinted implants with a larger diameter (RDIs). However, splinted NDIs supporting the all-on-four prosthesis led to the highest risk of overloading found in the study, due to the increase in compressive stress generated around the tilted implant when loading the cantilevered molar.

Clinical and tomographic comparison of dental implants placed by guided virtual surgery versus conventional technique: A split-mouth randomized clinical trial.

AIM: Our objective was to compare guided virtual surgery to conventional surgery in terms of angular deviation of single dental implants placed in the posterior mandible. MATERIALS AND METHODS: Patients with bilateral homologous single teeth missing in the posterior mandible were eligible for this split-mouth randomized clinical trial. Cone beam computed tomography (CBCT) was performed for virtual planning of implant position and manufacturing of the stereolithographic guides. One week after the surgery, a second CBCT scan was superimposed to the initial planning. Primary endpoint was the angular deviation between virtual and clinical implant position. Secondary endpoints were linear deviations and patient-reported outcomes collected with a questionnaire. RESULTS: Data from 12 patients were available for analysis. Angular deviation was significantly lower using stereolithographic guides as compared to conventional guides (2.2 ± 1.1° vs. 3.5 ± 1.6°, p = .042). Linear deviations were similar for both techniques in the coronal (2.34 ± 1.01 vs. 1.93 ± 0.95 mm) and apical (2.53 ± 1.11 vs. 2.19 ± 1.00 mm) dimensions (p Ëƒ .05). The selection of the surgical technique had no significant impact on the patient-reported outcomes. CONCLUSION: Our data suggest that the angular discrepancy between the virtual and the clinical implant position is slightly lower when using stereolithographic guides as compared to conventional guides.

Rehabilitations of a single element with one-piece implants with electrowelded needles: A different approach.

To ensure single dental implant stability, there are some approaches. The stabilization of a single-piece implant by welding it to a titanium needle allows immediate loading and promotes the final osseointegration. The aim of this case report study was an evaluation of long-term clinical outcomes of immediate loading in cases with bone atrophy in the canine region by welding single implant to a titanium needle. In two cases with maxillary atrophic anterior bone, single-piece titanium implants were used. As support structure, a Scialom-type stabilization titanium needle was used (diameter 1.2 mm and suitable length to obtain a bicortical positioning). These two elements were joined together using a Mondani intraoral welder. The implants immediately loaded by temporary restorations. The cases were followed for 24 years, and clinical outcomes were assessed. The use of this method, in the cases with maxillary atrophic anterior bone, allows immediate loading with a fixed acrylic prosthesis at the end of the surgical session. Clinical outcome was successful for 24 years. This approach is a successful method that allows immediate loading in atrophic bone.

Aspectos relevantes em implantes imediatos pós-exodonticos em área estética / Relevant aspects in esthetic outcomes of immediate implant placement following extraction

O objetivo deste artigo é apresentar um protocolo de tratamento de implantes imediatos de excelente previsibilidade estética e biológica. O caso clínico em questão apresenta comprometimento do elemento 21, que após o exame clínico e complementar constatou a fratura radicular irreparável. O planejamento foi a exodontia da raiz fraturada e instalação de implante imediato com provisionalização imediata, associando biomaterial para preenchimento do gap e enxerto conjunto na vestibular. Para restauração final foram confeccionadas uma coroa zircocerâmica como restauração definitiva do elemento 21 e uma microlâmina em dissilicato de lítio (IPS e.max) no dente 11 para harmonizar contorno e proporção entre os incisivos. O resultado final obtido mostrou-se favorável no follow-up de 1 ano, tanto nos aspectos biológicos dos tecidos peri-implantares e quanto à estética final. Com isso, concluímos que o protocolo adotado mostrou excelente previsibilidade.

The aim of this paper is to present a treatment protocol for excellent aesthetic and biological predictability with immediate implant. In the reported clinical case, the element 21 was compromised with irreparable root fracture. The planning was the extraction of the fractured root and immediate implant placement with immediate temporization, associating biomaterial for gap filling and conjunctive tissue graft. for the final restoration were made a zirco-ceramic crown in the element 21, and a lithium disilicate veneer (IPS e.max) in tooth 11 to harmonize contour and ratio between the incisors. The final result was favorable along the 1 year follow-up for both biological aspects of peri-implant tissues and final aesthetic. Thus, it could be concluded that the adopted protocol showed great predictability.

Loosening torque of Universal Abutment screws after cyclic loading: influence of tightening technique and screw coating.

PURPOSE: The purpose of this study was to evaluate the influence of tightening technique and the screw coating on the loosening torque of screws used for Universal Abutment fixation after cyclic loading. MATERIALS AND METHODS: Forty implants (Titamax Ti Cortical, HE, Neodent) (n=10) were submerged in acrylic resin and four tightening techniques for Universal Abutment fixation were evaluated: A - torque with 32 Ncm (control); B - torque with 32 Ncm holding the torque meter for 20 seconds; C - torque with 32 Ncm and retorque after 10 minutes; D - torque (32 Ncm) holding the torque meter for 20 seconds and retorque after 10 minutes as initially. Samples were divided into subgroups according to the screw used: conventional titanium screw or diamond like carbon-coated (DLC) screw. Metallic crowns were fabricated for each abutment. Samples were submitted to cyclic loading at 10(6) cycles and 130 N of force. Data were analyzed by two-way ANOVA and Tukey's test (5%). RESULTS: The tightening technique did not show significant influence on the loosening torque of screws (P=.509). Conventional titanium screws showed significant higher loosening torque values than DLC (P=.000). CONCLUSION: The use of conventional titanium screw is more important than the tightening techniques employed in this study to provide long-term stability to Universal Abutment screws.

In-vitro development of a temporal abutment screw to protect osseointegration in immediate loaded implants.

PURPOSE: In this study, a temporal abutment fixation screw, designed to fracture in a controlled way upon application of an occlusal force sufficient to produce critical micromotion was developed. The purpose of the screw was to protect the osseointegration of immediate loaded single implants. MATERIALS AND METHODS: Seven different screw prototypes were examined by fixing titanium abutments to 112 Mozo-Grau external hexagon implants (MG Osseous®; Mozo-Grau, S.A., Valladolid, Spain). Fracture strength was tested at 30° in two subgroups per screw: one under dynamic loading and the other without prior dynamic loading. Dynamic loading was performed in a single-axis chewing simulator using 150,000 load cycles at 50 N. After normal distribution of obtained data was verified by Kolmogorov-Smirnov test, fracture resistance between samples submitted and not submitted to dynamic loading was compared by the use of Student's t-test. Comparison of fracture resistance among different screw designs was performed by the use of one-way analysis of variance. Confidence interval was set at 95%. RESULTS: Fractures occurred in all screws, allowing easy retrieval. Screw Prototypes 2, 5 and 6 failed during dynamic loading and exhibited statistically significant differences from the other prototypes. CONCLUSION: Prototypes 2, 5 and 6 may offer a useful protective mechanism during occlusal overload in immediate loaded implants.

In-vitro development of a temporal abutment screw to protect osseointegration in immediate loaded implants

PURPOSE: In this study, a temporal abutment fixation screw, designed to fracture in a controlled way upon application of an occlusal force sufficient to produce critical micromotion was developed. The purpose of the screw was to protect the osseointegration of immediate loaded single implants. MATERIALS AND METHODS: Seven different screw prototypes were examined by fixing titanium abutments to 112 Mozo-Grau external hexagon implants (MG Osseous(R); Mozo-Grau, S.A., Valladolid, Spain). Fracture strength was tested at 30degrees in two subgroups per screw: one under dynamic loading and the other without prior dynamic loading. Dynamic loading was performed in a single-axis chewing simulator using 150,000 load cycles at 50 N. After normal distribution of obtained data was verified by Kolmogorov-Smirnov test, fracture resistance between samples submitted and not submitted to dynamic loading was compared by the use of Student's t-test. Comparison of fracture resistance among different screw designs was performed by the use of one-way analysis of variance. Confidence interval was set at 95%. RESULTS: Fractures occurred in all screws, allowing easy retrieval. Screw Prototypes 2, 5 and 6 failed during dynamic loading and exhibited statistically significant differences from the other prototypes. CONCLUSION: Prototypes 2, 5 and 6 may offer a useful protective mechanism during occlusal overload in immediate loaded implants.

In-vitro development of a temporal abutment screw to protect osseointegration in immediate loaded implants

PURPOSE: In this study, a temporal abutment fixation screw, designed to fracture in a controlled way upon application of an occlusal force sufficient to produce critical micromotion was developed. The purpose of the screw was to protect the osseointegration of immediate loaded single implants. MATERIALS AND METHODS: Seven different screw prototypes were examined by fixing titanium abutments to 112 Mozo-Grau external hexagon implants (MG Osseous(R); Mozo-Grau, S.A., Valladolid, Spain). Fracture strength was tested at 30degrees in two subgroups per screw: one under dynamic loading and the other without prior dynamic loading. Dynamic loading was performed in a single-axis chewing simulator using 150,000 load cycles at 50 N. After normal distribution of obtained data was verified by Kolmogorov-Smirnov test, fracture resistance between samples submitted and not submitted to dynamic loading was compared by the use of Student's t-test. Comparison of fracture resistance among different screw designs was performed by the use of one-way analysis of variance. Confidence interval was set at 95%. RESULTS: Fractures occurred in all screws, allowing easy retrieval. Screw Prototypes 2, 5 and 6 failed during dynamic loading and exhibited statistically significant differences from the other prototypes. CONCLUSION: Prototypes 2, 5 and 6 may offer a useful protective mechanism during occlusal overload in immediate loaded implants.

Loosening torque of Universal Abutment screws after cyclic loading: influence of tightening technique and screw coating

PURPOSE: The purpose of this study was to evaluate the influence of tightening technique and the screw coating on the loosening torque of screws used for Universal Abutment fixation after cyclic loading. MATERIALS AND METHODS: Forty implants (Titamax Ti Cortical, HE, Neodent) (n=10) were submerged in acrylic resin and four tightening techniques for Universal Abutment fixation were evaluated: A - torque with 32 Ncm (control); B - torque with 32 Ncm holding the torque meter for 20 seconds; C - torque with 32 Ncm and retorque after 10 minutes; D - torque (32 Ncm) holding the torque meter for 20 seconds and retorque after 10 minutes as initially. Samples were divided into subgroups according to the screw used: conventional titanium screw or diamond like carbon-coated (DLC) screw. Metallic crowns were fabricated for each abutment. Samples were submitted to cyclic loading at 106 cycles and 130 N of force. Data were analyzed by two-way ANOVA and Tukey's test (5%). RESULTS: The tightening technique did not show significant influence on the loosening torque of screws (P=.509). Conventional titanium screws showed significant higher loosening torque values than DLC (P=.000). CONCLUSION: The use of conventional titanium screw is more important than the tightening techniques employed in this study to provide long-term stability to Universal Abutment screws.

Mini-implante dentário como alternativa terapêutica para resolução de agenesia de incisivo lateral com cirurgia flapless e provisionalização imediata: relato de caso com 84 meses de acompanhamento / Mini dental implant as an alternative therapy for lateral incisor agenesis with flapless surgery and immediate provisionalization a case report with 84 months of follow-up

O presente estudo apresenta um caso de paciente do gênero masculino, 18 anos de idade, com agenesia do elemento 12, que optou pela utilização de um mini-implante associado à técnica de cirurgia sem retalho e realização de provisionalização imediata. Foi realizado acompanhamento clínico semanal no primeiro mês pós-implantação, não tendo sido observada qualquer complicação, assim como nos controles mensais seguintes, demonstrando sucesso nos resultados estéticos e funcionais. Após seis meses, a reabilitação protética foi finalizada com uma coroa In-Ceram e reabilitação cosmética do sorriso. O presente caso ressalta a importância do correto planejamento protético-cirúrgico, a experiência do profissional e os acompanhamentos clínicos de longo prazo

This case report illustrates a 18 years-old male patient with agenesis of tooth 22 receiving a mini dental implant with flapless surgery and immediate provisionalization. Postoperative control was performed every week in the first month and monthly thereafter demonstrating esthetic and functional success. Six months later, an In-Ceram crown was delivered for cosmetic smile design. This case highlights the importance of adequate surgical and prosthetic procedures, professional experience, and long-term clinical follow-ups.

Influence of platform switching on bone-level alterations: a three-year randomized clinical trial.

The concept of platform switching has been introduced to implant dentistry based on clinical observations of reduced peri-implant crestal bone loss. However, published data are controversial, and most studies are limited to 12 months. The aim of the present randomized clinical trial was to test the hypothesis that platform switching has a positive impact on crestal bone-level changes after 3 years. Two implants with a diameter of 4 mm were inserted crestally in the posterior mandible of 25 patients. The intraindividual allocation of platform switching (3.3-mm platform) and the standard implant (4-mm platform) was randomized. After 3 months of submerged healing, single-tooth crowns were cemented. Patients were followed up at short intervals for monitoring of healing and oral hygiene. Statistical analysis for the influence of time and platform type on bone levels employed the Brunner-Langer model. At 3 years, the mean radiographic peri-implant bone loss was 0.69 ± 0.43 mm (platform switching) and 0.74 ± 0.57 mm (standard platform). The mean intraindividual difference was 0.05 ± 0.58 mm (95% confidence interval: -0.19, 0.29). Crestal bone-level alteration depended on time (p < .001) but not on platform type (p = .363). The present randomized clinical trial could not confirm the hypothesis of a reduced peri-implant crestal bone loss, when implants had been restored according to the concept of platform switching.

Interproximal Papillae Reconstruction around Implant Using Subepithelial Connective Tissue Graft in Maxillary Anterior Region: A Case Series.

OBJECTIVES: The present study was undertaken to evaluate the effectiveness of interproximal papillae reconstruction around early loaded single implant using subepithelial connective tissue graft in maxillary anterior region. MATERIAL AND METHODS: Ten systemically healthy patients (mean age = 29.3 [SD 7.9] years) in need of dental implants in maxillary anterior region were included in the study. Interproximal papillae reconstruction around single implant using subepithelial connective tissue graft was applied. The donor palatal tissue was harvested by a "trap door approach". Subepithelial connective tissue graft was inserted in the pouch created on mesial and distal site of implant. Clinical and radiographic parameters were recorded around the each implant, including papillary height and papillary gingival contour, at baseline, 3 and 6 months after operation. RESULTS: The mesial papilla height was increased by 1.9 (SD 0.87) mm, P = 0.005 at 3 month and maintained at 1.5 (SD 0.97) mm, P = 0.007 at 6 months. The distal papilla height was increased by 2 (SD 0.66) mm, P = 0.004 at 3 month and maintained at 1.2 (SD 0.78) mm, P = 0.010 at 6 months. Assessment of papilla contour index showed 90% aesthetic success both for mesial and distal papilla at 6 months. CONCLUSIONS: It can be concluded that subepithelial connective tissue graft may be used to successfully augment the gingival papillae adjacent to single tooth implant restoration.

Ridge Augmentation Using Block Type of Autogenous Tooth Bone Graft Material in Severe Alveolar Bone Resorption of Single Tooth: Case Report

Masticatory function following implants replacing a second molar.

PURPOSE: The aim of this study was to obtain objective and standardized information on masticatory function and patient satisfaction following second molar single implant therapy. METHODS: Twenty adult patients, who had restored second molar single implants more than 1 month before the study, were enrolled in this study. All patients received a chewing test using peanuts before and after insertion of the implant prosthesis, with a questionnaire and visual analogue scale (VAS) to evaluate the effect of second molar single implant therapy. RESULTS: This study obtained standardized information on the masticatory function objectively (e.g., P, R, X(50)) before (Pre-insertion) and after insertion (Post-insertion) of the implant prosthesis. Masticatory performance (P) after insertion of the implant prosthesis significantly increased from 67.8±9.9 to 84.3±8.5% (P<0.0001). With the implant prosthesis, the P value increased by 24%. The masticatory efficiency index (R) of Post-insertion is higher than that of Pre-insertion (P<0.0001). With the implant prosthesis, the R value increased by 29%. The median particle size (X(50)) of Post-insertion is lower than that of Pre-insertion (P<0.0001). More than 90% of the patients were satisfied with the second molar single implant therapy from a functional point of view. CONCLUSIONS: These findings indicate that a second molar single implant can increase masticatory function.

Masticatory function following implants replacing a second molar

PURPOSE: The aim of this study was to obtain objective and standardized information on masticatory function and patient satisfaction following second molar single implant therapy. METHODS: Twenty adult patients, who had restored second molar single implants more than 1 month before the study, were enrolled in this study. All patients received a chewing test using peanuts before and after insertion of the implant prosthesis, with a questionnaire and visual analogue scale (VAS) to evaluate the effect of second molar single implant therapy. RESULTS: This study obtained standardized information on the masticatory function objectively (e.g., P, R, X50) before (Pre-insertion) and after insertion (Post-insertion) of the implant prosthesis. Masticatory performance (P) after insertion of the implant prosthesis significantly increased from 67.8+/-9.9 to 84.3+/-8.5% (P<0.0001). With the implant prosthesis, the P value increased by 24%. The masticatory efficiency index (R) of Post-insertion is higher than that of Pre-insertion (P<0.0001). With the implant prosthesis, the R value increased by 29%. The median particle size (X50) of Post-insertion is lower than that of Pre-insertion (P<0.0001). More than 90% of the patients were satisfied with the second molar single implant therapy from a functional point of view. CONCLUSIONS: These findings indicate that a second molar single implant can increase masticatory function.