Comparison of the soft and hard peri‐implant tissue dimensional changes around single immediate implants in the esthetic zone with socket shield technique versus using xenograft: A randomized controlled clinical trial

Abstract

Objective Compare the dimensional changes of the peri‐implant soft and hard tissues clinically and radiographically around single immediate implants in the esthetic zone with socket shield technique versus filling the buccal gap with xenograft. Materials and methods Forty‐two patients with a single non‐restorable tooth in the esthetic zone replaced with an immediate implant were randomly assigned either to the socket shield technique (test) or to grafting the buccal gap with xenograft (control). The vertical and horizontal buccal bone resorption were measured 6‐months following implant placement. The esthetic outcomes were evaluated by assessing the Pink Esthetic Score (PES) and the amount of midfacial mucosal alteration, in addition to patient satisfaction assessment through a Visual Analogue Scale (VAS) based questionnaire 1‐year following implant restoration. Results The present study showed that the socket shield group yielded significantly less vertical and horizontal buccal bone resorption of 0.35 (±0.62) mm and 0.29 (±0.34) mm compared to 1.71 (±1.02) mm and 1.45 (±0.72) mm in the xenograft group respectively. Also, there was a significantly greater midfacial mucosal recession in the xenograft group of 0.466 (±0.58) mm compared to midfacial mucosal coronal migration of 0.45 (±0.75) mm in the socket shield group. However, there was no statistically significant difference regarding the total PES and patient satisfaction in both treatment groups. Conclusion The socket shield technique can preserve hard and soft peri‐implant tissues following immediate implant placement. (http://clinicaltrials.gov Identifier: NCT03684356).

The peri‐implant mucosa color: A systematic appraisal of methods for its assessment and clinical significance

“…Full‐text assessment was performed for 327 articles. Based on the predetermined inclusion criteria, 121 articles were included 14–20,22,23,30–141 . The reason for exclusion of the other 196 articles is available in the Appendix (Table S1).…”

“…A total of 93 studies (76.9%) described PMC using esthetic indices with predetermined grading scores. [16][17][18][31][32][33][34][35][36]38,39,[42][43][44][45][46][47][48][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][70][71][72][73][74][75][76][77][80][81][82][84][85][86][87][88][89][90][91][92][93]…”

“…The pink esthetic score (PES) 16 was utilized in 58 studies (62.4% of the studies assessing PMC with an index), 16,17,[33][34][35]46,[49][50][51][52][53][54][56][57][58][59][60][61][62][63][64][65][66][69][70][71]74,76,79,81,83,84,94,[96][97][98][99][100]105,[107][108][109][110][111][112][114][115][116][118][119][120][121][122]124,127,…”

“…In 14 studies, the evaluation of PMC-as a parameter of the PESprovided information related to the color match with the gingiva of the reference tooth, without additional comparisons. 16,17,50,52,70,76,83,84,94,[98][99][100]107,108 PMC assessment as a part of the PES evaluation was also utilized for assessing changes/stability of the color of peri-implant soft tissue over time in 15 studies, 34,35,50,70,72,80,97,98,[110][111][112][113]115,116,119 while the majority (N = 29) of the articles reporting PMC from the PES evaluation utilized this parameter for comparing different treatment groups or interventions (e.g. immediate vs. delayed implants, different implant systems, implants restored with different type of abutment, etc.).…”

“…immediate vs. delayed implants, different implant systems, implants restored with different type of abutment, etc.). 35,46,51,53,54,[56][57][58][59][60][61][62][63][64][65][66]74,81,105,116,[119][120][121][122]124,127,128,133,134 Similarly, 10 studies reporting PMC as a parameter of the PES/WES, provided information on color discrepancy with contralateral reference tooth only, without additional comparisons. 17,31,37,38,41,43,47,55,90,117 PMC as a part of the PES/WES assessment was utilized to evaluate color changes over time in 7 studies 42,45,80,102,103,106,139 and to compare color differences among different groups in 9 studies.…”