Marginal Bone Loss at Implants: A Retrospective, Long-Term Follow-Up of Turned Brånemark System® Implants


Dr. Solweig Sundén Pikner, Department of Oral Radiology, Postgraduate Dental Education Center, Box 1126, SE-701 11 Örebro, Sweden; e-mail:


Background: Lately, presence of progressive bone loss around oral implants has been discussed.

Purpose: The aim of this study was to report in a large patient group with different prosthetic restorations marginal bone level and its change as measured in radiographs obtained from prosthesis insertion up to a maximum 20 years in service. Further, it also aimed to study the impact of gender, age, jaw, prosthetic restoration, and calendar year of surgery.

Materials and Methods: Out of 1,716 patients recorded for clinical examination during 1999, 1,346 patients (78.4%) could be identified. A total of 640 patients (3,462 originally installed Brånemark System® implants, Nobel Biocare, Göteborg, Sweden) with a follow-up of ≥5 years were included in the study, while patients with continuous overdentures and augmentation procedures were not. Distance between the fixture/abutment junction (FAJ) and the marginal bone level was recorded.

Results: The number of implants with a mean bone level of ≥3 mm below FAJ increased from 2.8% at prosthesis insertion to 5.6% at year 1, and 10.8% after 5 years. Corresponding values after 10, 15, and 20 years were 15.2, 17.2, and 23.5%, respectively. Implant-based bone loss was as a mean 0.8 mm (SD 0.8) after 5 years, followed by only minor average changes. Mean bone loss on patient level followed a similar pattern. Disregarding follow-up time, altogether 183 implants (107 patients) showed a bone loss ≥3 mm from prosthesis insertion to last examination. Significantly larger bone loss was found the older the patient was at surgery and for lower jaw implants.

Conclusions: Marginal bone support at Brånemark implants was with few exceptions stable over years.