A 9-Year Longitudinal Follow-up of IS-III Implants: Clinical Outcomes from 2017 to 2025

Case Summary 🔎

Patient Information

• Age/Gender: 62-year-old, Male

• Past Medical History: Hypertension and Aspirin therapy

• Drug allergy: None

• Chief complaint: "I want to extract the mobile tooth and proceed with the necessary treatmen."

Introduction

In early 2017, IS-III implants were placed at the #14 and #47 sites in extremely soft D4 bone. Despite the poor bone quality, the IS-III system achieved high primary stability of 40 N/cm following layered ridge preservation. A follow-up extending to December 2025—representing nearly 9 years—confirmed excellent marginal bone maintenance with no evidence of resorption. This case demonstrates the superior long-term reliability and functional stability of IS-III implants in challenging D4 bone conditions over almost a decade.

Diagnosis

• Initial Findings: * #14 Severe mobility (Non-salvageable)

• #47 Missing tooth & #48 Chronic periodontitis

  
  

Treatment plan: 

• 1. Atraumatic extraction of #14 & #48

• 2. Ridge preservation at #14 (Layered Grafting Technique)

• 3. IS-III Implant placement at #14 & #47

Case Presentation

1️⃣ Pre-Op

• Initial panoramic radiograph reveals advanced bone loss and periapical/periodontal

• Panoramic view after the extraction of #14 and #48 to eliminate the foci of infection.

2️⃣ Surgery (#14, #47)

➊ #14 Surgery

• 2017.01 At the #14 site, atraumatic extraction and meticulous socket debridement were performed.

• For ridge preservation, a layered grafting technique was employed: an allograft was placed as the base layer, followed by a BCP overlay.

• The site was then covered with a collagen membrane and sealed with an autogenous soft tissue graft harvested from the extraction site.

• Postoperative follow-up after 2 weeks: Excellent soft tissue healing and stable graft maintenance.

• Five months after ridge preservation, an IS-III implant (Ø4.0 x 11 mm) was placed at the #14 site.

• Despite the D442 bone density, a high initial stability of 40 N/cm was achieved.

➋ #47 Surgery

•  The IS-III implant (Ø5.0 x 10 mm) was placed into the healed ridge at the #47 site.

• Despite the D112 bone density, an initial stability of 40 N/cm and an ISQ of 83 were achieved.

• The procedure was completed with healing abutment connection and suturing

3️⃣ Final restoration (#47, #14)

➊ #14 Final restoration

• #14 Final restoration was delivered 2 months post-implantation

➋ #47 Final restoration

• #47 final impression was taken one month after implant placement.

• Two weeks later, the final zirconia restoration was delivered.

4️⃣ Follow-up (Apr 2017 – Dec 2025 Long-term)

• Annual panoramic radiographs were taken consecutively from April 2017 to December 2025.

• The implants have been perfectly maintained with zero marginal bone loss over the almost 9-year period.

• Excellent clinical stability and functional longevity were confirmed.

Conclusion

This case provides a 9-year follow-up (April 2017 – December 2025) of IS-III implants in varied bone conditions.

By utilizing a layered ridge preservation technique at the #14 site (D442 bone) and ensuring stable placement at the #47 site (D112 bone), we were able to achieve predictable initial stability. Annual panoramic radiographs over nearly a decade show that the marginal bone levels have remained stable without significant loss.

In conclusion, this long-term observation suggests that the IS-III system can provide reliable functional results and maintain peri-implant bone health when combined with appropriate surgical management, even in challenging bone densities