Clinical and Aesthetic Outcome with Post‐Extractive Implants with or without Soft Tissue Augmentation: A 2‐Year Randomized Clinical Trial

Abstract

This prospective study demonstrates the effectiveness of placing a soft tissue graft at the time of immediate implant placement in the aesthetic zone. At the 2-year follow-up, test group revealed a better aesthetic outcomes and stable facial soft tissues compared with control group.

The Effect of Subepithelial Connective Tissue Graft Placement on Esthetic Outcomes After Immediate Implant Placement: Systematic Review

“…All studies used subepithelial connective tissue (CT) grafts. Immediate provisionalization was performed in six of 10 studies 24,44‐48 . Healing abutment was placed after immediate implantation in one study 29 .…”

“…Another three studies used a two‐stage approach 49–51 . Xenografts were placed after implantation in six studies, 24,44,45,47,48,50 and one study used a combination of xenograft and allograft 46 . Smokers were excluded in six studies 24,44‐46,48,51 (Table 1).…”

“…Two RCTs scored five 47 and four 48 low risk of bias items of nine assessment items, respectively (see supplementary Appendix 4 in online Journal of Periodontology ). The mean NOS score was 5.5 ± 0.8 (range, 5 to 7) in eight cohort studies (see supplementary Appendix 5 in online Journal of Periodontology ).…”

Bone volume changes after immediate implant placement with or without flap elevation

“…While in the entire test group all thin biotype cases obtained a satisfactory PES value only 75% of the control group obtained sufficient PES values. Good PES was obtained in 0% and 57% of the thin biotype cases in the control and test groups respectively (Miglioratti et al 2013). Bianchi & Sanfilippo (2004) observed a better emergence profile as well as an increased gingival thickness at immediate implants that received a subepithelial connective graft with respect to the control sites at 1 to 9 years.…”

“…Some authors have tried to regenerate the missing bone between the implant surface and the socket walls using various bone augmentation techniques Benic et al 2012, Koh et al, 2011. Others have advocated thickening the soft tissues by means of a connective tissue graft at the time of surgery (Miglioratti et al 2013). Last but not least, experimental studies in dogs have suggested that a flapless approach could minimize buccal bone resportion (Blanco et al 2008).…”