Esthetics and bone changes of immediate implants with or without vascularized interpositional periosteal connective tissue grafting: A 2‐year randomized controlled trial

Abstract

Objectives To compare esthetics at single immediately placed implants with and without soft tissue augmentation. Materials and Methods Patients with non‐restorable maxillary teeth in the esthetic zone were assigned into 2 groups: immediately placed implants with simultaneous vascularized interpositional periosteal connective tissue grafting (VIP‐CTG) or non‐grafted immediately placed implants (NG). The outcomes included: pink esthetic score (PES), gingival thickness, keratinized tissue width, buccal bone changes, marginal bone loss, pain, and satisfaction. Results Eighteen implants were included. At 2 years the mean value for PES was 12 ± 3.2 for the VIP‐CTG and 12.9 ± 1.3 for the NG (p = .855). Mucosal thickness and keratinized tissue width showed no statistically significant difference between the two groups (p = .253) and (p = .931) respectively. Clinically buccal bone showed mean bone loss of 2.03 ± 1.57 mm for VIP‐CTG and 1.09 ± 1.3 mm for NG (p = .247) and radiographically showed 1.67 ± 0.84 mm at the VIP‐CTG and 1.16 ± 0.47 mm at the NG (p = .118). No statistically significant difference between both groups was demonstrated regarding marginal bone level changes (p = .142), pain (p = .622), or satisfaction (p = .562) at any time point. Conclusion Simultaneous soft tissue grafting with immediate implant placement did not provide a more favorable outcome regarding esthetics or alveolar bone preservation effect. Undisturbed healing with the least surgical intervention seems to provide more favorable outcomes.

Single immediate implant placement in the maxillary aesthetic zone with and without connective tissue grafting: Results of a 5‐year randomized controlled trial

“…Both patient groups reported high satisfaction rates, without a significant difference between the groups. This is in line with Naiem et al's (2023) findings. The overall patient satisfaction score is comparable with that described by Slagter et al (2021).…”

“…The MBLs were stable throughout the follow‐up period and were not different between the groups, which is in line with Naiem et al's (2023) results. Our reported significant gain in mesial MBL in the control group compared with the test group from T 12 to T 60 could also be explained by the fact that the supraperiosteal vascularization had not been disturbed when inserting a CTG and thereby, possibly, bone resorption was prevented (Cosyn et al, 2013; Mazzocco et al, 2017; Vignoletti et al, 2012).…”

“…High PES scores were recorded at the 5‐year follow‐up, and were not different for both groups. The same was found by Naiem et al (2023), although they used the Fürhauser et al (2005) PES scoring system and we used Belser et al's (2009) scoring system. Noelken et al (2018) also reported high PES scores in their retrospective study while using Fürhauser et al's (2005) scoring system, without differences between the groups.…”

Evaluation of buccal bone resorption in immediate implant placement in thin versus thick buccal bone plates: An 18‐month follow‐up prospective cohort study

“…Buccal bone is less accurately exhibited in CBCT, underestimating thin bone dimension, further complicating assessment 15–21 . To eliminate the shortcomings of the CBCT, the buccal bone changes measuring device introduced by 22 have proven itself to be more accurate and less invasive 23–25 …”

“…[15][16][17][18][19][20][21] To eliminate the shortcomings of the CBCT, the buccal bone changes measuring device introduced by 22 have proven itself to be more accurate and less invasive. [23][24][25] Accordingly, this prospective clinical trial was designed to examine the effect of labial bone thickness on the buccal bone resorption in immediate implants and assess the accuracy of buccal bone measurement methods using two different techniques.…”