No abstract

Introduction There are mixed results regarding the aesthetic advantage of immediate provisionalization of dental implants. Therefore, this study aimed to compare facial mucosal level of single immediately placed implants with and without immediate provisionalization. Methods Single implants were immediately placed to replace a hopeless maxillary anterior or premolar tooth in 40 subjects. Each implant was randomly assigned to receive a non‐occluding temporary crown or a healing abutment after implant placement. At 4 months, these implants were permanently restored and followed up for 12 months. Clinical and radiographic parameters were measured and compared. Results The implant survival rate at 12 months in the test and control group was 90% and 100%, respectively. Mid‐facial mucosal marginal level and papilla height changes were minimal within groups, and no significant differences were found between the two groups. The amount of marginal bone remodelling was modest, with no significant difference between the two groups. Radiographic bone changes were not statistically different between the groups, except for the vertical crestal bone resorption. Conclusion Immediate implant placement with or without provisionalization can achieve stable vertical soft tissue level for 12 months as compared to pre‐extraction level. However, immediate provisionalization was not able to improve the aesthetic outcome further.

Background Immediately placed single implants with either immediate provisionalization (test) or delayed restoration (control) were followed for up to 1 year in our previous randomized clinical trial. Peri‐implant tissues continue to remodel after implants are in function. Therefore, the primary aim of this study was to evaluate the facial mucosal level changes in the intermediate term between the two groups and to study potential factors influencing the mucosal level change. Methods Patients who had already completed the previous clinical trial by receiving a single immediately placed implant were re‐invited to this study. The facial mucosal level as well as the other peri‐implant hard and soft tissue dimensions and conditions were measured clinically, radiographically and with ultrasound. These data were compared between the test and control implants. The mucosal level change as the function of the final crown contour, measured as the abutment‐crown angle (ACA), was estimated with a linear regression model. Results Twenty‐eight patients (n of test/control = 16/12) with a mean 30‐month follow‐up were recruited. The mean mucosal level change was ‐0.38 mm (control) and 0.06 mm (test), without statistical difference between the two groups. The other clinical, radiographic, and ultrasound parameters were not statistically different. ACA was statistically significant associated with the recession (P = 0.02). The estimate effect was 0.25 mm per 10° increase (adjusted R2 = 0.18; 95% CI, 0.02 to 0.49 mm). After adjusting for vertical implant position, implant abutment angle and the group, the effect became borderline significant (P = 0.09). Conclusions Peri‐implant tissues, including the mucosal level change of immediately placed implants with either immediate provisionalization or delayed restoration remained stable and did not differ between the groups in the intermediate term. The final crown angle, influenced by implant position and abutment angle, might be associated with mucosal margin level change.