AID Practical Impact Award 2026: A Long-Term Comparison of Bone-Level and Tissue-Level Implants (english version)
What role does implant design play in long-term peri-implant health? Dr. Emilio Couso-Queiruga and Dr. Clemens Raabe explored this question through follow-up examinations conducted an average of eleven years after implant placement.
Zürich, October 2026 – The Alliance for Implant Dentistry (AID) honored Dr. Emilio Couso-Queiruga and Dr. Clemens Raabe with the Practical Impact Award 2026. The award recognizes their comparative study of bone-level and tissue-level implants, which assessed implant survival as well as peri-implant diseases and associated factors.
With this award, AID recognizes scientific work for its scientific quality, with particular emphasis on its high clinical and practical value for implant dentistry.
In their single-center cross-sectional study, the research team at the University of Bern investigated whether bone-level and tissue-level implants in anterior and premolar sites differ in their long-term outcomes with respect to implant survival and peri-implant diseases. Implant diameter and other potential risk indicators were also considered.
The study included 266 patients with an initial total of 336 implants, with follow-up examinations conducted an average of 11 years after implant placement. Following the loss of four implants, 332 implants were available for peri-implant tissue assessment: 166 bone-level and 166 tissue-level implants. Both types showed high survival rates of 99.4% (bone-level) and 98.2% (tissue-level).
Contrary to the initial hypothesis that peri-implant diseases would be more prevalent around bone-level than tissue-level implants, no statistically significant overall difference in the prevalence of these diseases was observed between the two implant designs. Peri-implantitis was present at 11.4% of bone-level and 9.0% of tissue-level implants.
Interesting differences emerged in relation to implant diameter and tissue thickness: implants with a diameter of 3.3 mm showed a lower prevalence of peri-implantitis than those with a diameter of 4.1 mm (7.2% vs. 13.3%). The risk was particularly low when a narrow diameter was combined with a tissue-level design. In this group, the peri-implantitis rate was 4.8% (compared with 9.6% for narrow-diameter bone-level implants). Greater peri-implant mucosal thickness was associated with a lower prevalence of mucositis and peri-implantitis. Both diseases were more common at higher plaque scores, while peri-implantitis was more common among smokers.
Dr. Clemens Raabe and Dr. Emilio Couso-Queiruga offer a clinical perspective on the findings:
We were surprised that bone-level implants did not show a higher risk of disease over the long term. Carefully designed restorations, alongside ideal three-dimensional implant positioning, may have contributed to this finding, since this is a particular area of risk for bone-level implants. Evidence for the influence of a well-designed emergence profile on peri-implant health continues to grow. Our findings did, however, confirm how strongly patient factors and soft tissue shape the outcome.
The study provides valuable data on peri-implant health an average of eleven years after implant placement. Its cross-sectional design identifies associations but does not allow conclusions about cause and effect. The findings relate to a single implant system with two diameters used at non-molar sites. To verify the findings and assess their generalizability, the researchers recommend larger, more diverse patient cohorts and longitudinal studies involving multiple implant systems.
AID congratulates Dr. Emilio Couso-Queiruga and Dr. Clemens Raabe, along with the research team, on receiving the award. Their work provides additional data for the long-term assessment of both implant designs and highlights why peri-implant health, alongside implant survival, is a central component of long-term patient care.
