Abstract
Background: Wedge-shaped implants have been proposed as a minimally invasive solution for narrow alveolar ridges, aiming to avoid bone augmentation. While the short-term results are promising, long-term clinical evidence remains limited. Methods: This multicenter prospective single-arm cohort study reports the 7-year outcomes of tissue-level wedge-shaped implants (1.8 mm thickness) placed without grafting in horizontally atrophic ridges (mean thickness 3.73 ± 0.36 mm). Clinical and radiographic evaluations were performed on 45 implants (34 patients). Results: At the 7-year post-loading follow-up, the implant survival rate was 95.5%, with two failures recorded-one early loss and one due to peri-implantitis. Peri-implant mucositis was observed in 5 implants (11.4%), while peri-implantitis was diagnosed in 3 implants (6.8%). No mechanical complications were reported. The mean marginal bone loss (MBL) was 1.45 ± 1.41 mm, measured relative to the implant shoulder. Multivariate linear regression identified older age (β = +0.040; p = 0.012) and mandibular implant placement (β = +1.39; p = 0.007) as significant predictors of greater bone loss. Conclusions: Wedge-shaped implants demonstrated high long-term survival and stable marginal bone levels in narrow ridges without the need for bone augmentation. Age and mandibular location negatively influenced long-term bone stability, while smoking, gender, and history of periodontitis were not significant predictors.