July 2015

Scientific articles

Replacement of missing posterior tooth with off-center placed single implant: Long-term follow-up outcomes

Research team

Javier Flores
Eduardo Anitua
Alia Murias-Freijo
Mohammad Hamdan Alkhraisat

Statement of problem

The distal offset placement of a single implant to replace a single tooth would overcome the shortcomings of the placement of a single wide implant in the posterior region. However, long-term evaluation is still-lacking.


The purpose of this study was to evaluate the long-term outcomes of patients treated with a single tooth restoration supported by a distal-offset placed implant.

Material and methods

Thirty-one patients with a single restoration supported by an off-center placed implant were evaluated. The patients' demographic data were described. The known implant length was used as a reference to calibrate the linear measurements on digital periapical radiographs. Implant details, survival, and prosthetic complications were analyzed.

The implant survival rate was analyzed with the Kaplan-Meier method.


Thirty-four implants were placed with a distal offset to support single-tooth restorations. Twenty patients were women, and patient age was 56 ± 12 years. The implants had a follow-up time from loading up to 10 years (average: 4 ± 3 years). Most of the implants were inserted in type II bone, and 85% were placed in the molar region. The distal offset placement of the implant and the selection of a wide-diameter implant resulted in a mesial bone loss of 0.85 ± 0.57 mm and distal bone loss of 0.83 ± 0.68 mm. One implant failed after 4 months from insertion, resulting in a cumulative survival rate of 97.1%. No prosthetic complications were registered.


The distal offset placement of an implant is an efficient option for restoring a single missing posterior tooth when mesiodistal space is limited.

Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

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