Purpose: To evaluate, within a period of 5 years, the bone level in mesial, distal, palatal, and

buccal areas around scalloped shape implants immediately placed and loaded with temporary

crowns fixed on final prefabricated abutments, and also to evaluate the thickness of buccal

bone. Materials and Methods: 18 implants were inserted and loaded immediately using

computer-assisted design/computer-assisted manufacturing technology on 18 patients to replace

single tooth in the esthetic part of the maxilla. The marginal bone level across the scalloped

implant neck was measured mesially and distally using intraoral standardized radiographs after

crown fixations and 1, 3, and 5 years later. Cone beam computed tomography para-axial cuts

images were used to measure bone level buccally and palatally from the implant neck to the

implant-to bone contact after 5 years of loading and to evaluate the thickness of the buccal bone

at the implant neck and 4 mm apically, immediately after implant placement and 5 years later.

Results: All implants were assessed clinically and radiologically after 5 years. No implant

failure was recorded, and the average marginal bone variation on mesial and distal sites was

0.114 ± 0.135 mm at crown cementation, 0.239 ± 0.158 mm 1 year later, 0.233 ± 0.182 mm 3

years later, and 0.180 ± 0.182 mm 5 years later. Our findings indicate that at T0, the average

thickness of the buccal bone was 2.27 mm at implant neck M0 (ranging from 1.9 to 2.4) and

2.33 mm at 4 mm apically to the implant neck M1 (ranging from 1.9 mm to 2.9 mm). By T4,

the mean had decreased to 1.94 mm at M0 (with a range of 1.7 mm to 2.3 mm) and 2.14 mm at

M1 (with a range of 1.8 mm to 2.4 mm). After 5 years the mean changes at buccal and palatal

bone for all implants were +0.187 ± 0.52 mm and +0.06 ± 0.38 mm respectively.

Minor prosthetic problems were observed over the five years: incisal ceramic chipping

occurred in two crowns, and two crowns were replaced for esthetic reasons after one year. No

loosening of crowns or abutments was reported. Conclusions: Scalloped neck implants

demonstrated a comparable behavior to regular neck implants with similar designs in an

immediate implantation and temporization protocol over a five-year period.