Facial mucosal level of single immediately placed implants with either immediate provisionalization or delayed restoration: An intermediate‐term study

Abstract

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.

Immediate implant placement with or without immediate provisionalization: A systematic review and meta‐analysis

“…The reasons for exclusion are listed in Supplementary Table 1. Eight articles on seven RCTs fully met the selection criteria for a qualitative and quantitative analysis (De Rouck et al, 2009; Shibly et al, 2010; Rieder et al, 2016; Gastaldi et al, 2017; Crespi et al, 2018; Chan et al, 2019; Bushahri et al, 2021; Slagter, Raghoebar, et al, 2021). Bushahri et al (2021) and Chan et al (2019) related to the same study, yet provided data on other outcome variables.…”

“…Eight articles on seven RCTs fully met the selection criteria for a qualitative and quantitative analysis (De Rouck et al, 2009; Shibly et al, 2010; Rieder et al, 2016; Gastaldi et al, 2017; Crespi et al, 2018; Chan et al, 2019; Bushahri et al, 2021; Slagter, Raghoebar, et al, 2021). Bushahri et al (2021) and Chan et al (2019) related to the same study, yet provided data on other outcome variables. Meta‐analyses could be performed on vertical midfacial soft tissue changes, implant survival, mesial and distal papillary changes, marginal bone‐level change, probing depth, and bleeding on probing.…”

“… c Data based on 3‐year results from Bushahri et al (2021) on a reduced number of patients and implants. …”

“…Four studies reported on marginal bone‐level changes following IIP + IP and IIP (De Rouck et al, 2009; Shibly et al, 2010; Gastaldi et al, 2017; Bushahri et al, 2021). Radiographic data from the Chan et al (2019) study were extracted from the 3‐year follow‐up paper published by Bushahri et al (2021). In the Shibly et al (2010) study, radiographic data were based on only 49 patients.…”

Interdisciplinary management of recession defects on maxillary single tooth implants: Diagnosis and treatment strategies

“…As seen in the first clinical report, the unintended consequence of poor facial angulation is excessive subgingival contour of the abutment that places pressure on the peri‐implant soft tissues (abutment level correction) thus causing recession 16 . In addition, several recent in vitro studies have addressed the threshold of angle correction to deliver 25 Ncm ITV to the abutment screw, fatigue load to failure, and screw loosening of ASC abutments 17 .…”