TY - JOUR
T1 - Soft Tissue Preservation and Pink Aesthetics around Single Immediate Implant Restorations
T2 - A 1-Year Prospective Study
AU - Cosyn, Jan
AU - De Bruyn, Hugo
AU - Cleymaet, Roberto
PY - 2013
Y1 - 2013
N2 - Purpose: (1) To document soft tissue aspects using a specific protocol for immediate implant treatment (IIT) following single-tooth removal; (2) to evaluate whether this protocol allows preservation of pink aesthetics as objectively assessed. Materials and Methods: Patients with a thick gingival biotype and intact buccal bone wall upon extraction of a single tooth in the aesthetic zone (15-25) were consecutively treated. The protocol included flapless extraction and implant surgery, socket grafting, immediate nonocclusal loading with a screw-retained provisional crown, and replacement by a permanent crown 6 months thereafter. The outcome was assessed after 3, 6, and 12 months. Cases demonstrating major alveolar process remodeling and/or advanced midfacial recession (>1mm) at 3 months were additionally treated with a connective tissue graft (CTG). The emergence profile of the provisional crown was replicated for all permanent crowns. Results: Twenty-two patients (12 men, 10 women; mean age 50) were treated after tooth extraction for nonperiodontal reasons using a novel bone condensing implant with variable-thread design, conical connection, and platform switch (NobelActive®, Nobel Biocare, Göteborg, Sweden). One implant failed and mean marginal bone loss was 0.1mm (p=059). Temporary mesial papilla reduction occurred, whereas distal papilla reduction was permanent (mean 0.5mm; p=001). At 3 months, five cases demonstrated major alveolar process remodeling and two advanced midfacial recession. Hence, slight initial decline in the pink esthetic score (PES) (p=053) was observed. CTG resulted in a steady improvement of the PES after 3 months (p≤.037). At 12 months, pink aesthetics (mean PES 12.15) was comparable to the preoperative status (mean PES 11.86; p=293). Distal papillae had significantly deteriorated (p=020) in this time span, whereas midfacial contour had significantly improved (p=005). Conclusions: Preservation of pink aesthetics is possible following IIT. However, to achieve that, CTG may be necessary in about one-third of the patients. Major alveolar process remodeling is the main reason for additional treatment. © 2012 Wiley Periodicals, Inc.
AB - Purpose: (1) To document soft tissue aspects using a specific protocol for immediate implant treatment (IIT) following single-tooth removal; (2) to evaluate whether this protocol allows preservation of pink aesthetics as objectively assessed. Materials and Methods: Patients with a thick gingival biotype and intact buccal bone wall upon extraction of a single tooth in the aesthetic zone (15-25) were consecutively treated. The protocol included flapless extraction and implant surgery, socket grafting, immediate nonocclusal loading with a screw-retained provisional crown, and replacement by a permanent crown 6 months thereafter. The outcome was assessed after 3, 6, and 12 months. Cases demonstrating major alveolar process remodeling and/or advanced midfacial recession (>1mm) at 3 months were additionally treated with a connective tissue graft (CTG). The emergence profile of the provisional crown was replicated for all permanent crowns. Results: Twenty-two patients (12 men, 10 women; mean age 50) were treated after tooth extraction for nonperiodontal reasons using a novel bone condensing implant with variable-thread design, conical connection, and platform switch (NobelActive®, Nobel Biocare, Göteborg, Sweden). One implant failed and mean marginal bone loss was 0.1mm (p=059). Temporary mesial papilla reduction occurred, whereas distal papilla reduction was permanent (mean 0.5mm; p=001). At 3 months, five cases demonstrated major alveolar process remodeling and two advanced midfacial recession. Hence, slight initial decline in the pink esthetic score (PES) (p=053) was observed. CTG resulted in a steady improvement of the PES after 3 months (p≤.037). At 12 months, pink aesthetics (mean PES 12.15) was comparable to the preoperative status (mean PES 11.86; p=293). Distal papillae had significantly deteriorated (p=020) in this time span, whereas midfacial contour had significantly improved (p=005). Conclusions: Preservation of pink aesthetics is possible following IIT. However, to achieve that, CTG may be necessary in about one-third of the patients. Major alveolar process remodeling is the main reason for additional treatment. © 2012 Wiley Periodicals, Inc.
UR - http://www.scopus.com/inward/record.url?scp=84893200587&partnerID=8YFLogxK
U2 - 10.1111/j.1708-8208.2012.00448.x
DO - 10.1111/j.1708-8208.2012.00448.x
M3 - Article
SN - 1523-0899
VL - 15
SP - 847
EP - 857
JO - Clinical Implant Dentistry and related research
JF - Clinical Implant Dentistry and related research
IS - 6
ER -