Immediate implant placement and provisionalization: Aesthetic outcome 1 year after implant placement. A prospective clinical multicenter study

Abstract

Background Prospective aesthetic outcomes on a high number of patients after immediate implant placement and provisionalization (IIPP) are lacking. Purpose To analyze the aesthetic outcome after IIPP. Materials and Methods One hundred consecutive patients with a failing maxillary incisor were provided with an immediately placed and provisionalized nonloaded implant using a flapless procedure and palatal implant positioning. The remaining gap buccally was filled with a bone substitute. Preoperatively (T0), 2 weeks postoperatively (T1), direct after placement of the permanent crown (T2), and 1 year after IIPP (T3), standardized light photographs were made. Change in aesthetic score was the primary outcome measure. Both the white aesthetic score (WES) and pink aesthetic score (PES) were used. Results In the first year postsurgery, the mean total‐WES and total‐PES scores raised from 4.5 to 8.2, and from 9.9 to 12.1, respectively. The mean PES scores for mesial and distal papilla, soft tissue marginal level, contour, color, and texture, raised significantly (P < .05), while the alveolar process contour, on average, remained stable from T0 to T3. Conclusions Within the limitations of this 1‐year research, it may be concluded that, following this minimal invasive IIPP procedure, a high aesthetic outcome was achieved.

Does the pre-operative buccal soft tissue level at teeth or gingival phenotype dictate the aesthetic outcome after flapless immediate implant placement and provisionalization? Analysis of a prospective clinical case series

“…In addition, they stated that early placed implants tended to be superior to delayed-placed implants with respect to STL level. So cautiously, it can be stated that performing FIIPP conform this standardized protocol [ 13 , 15 ] and shows better results at the point of soft tissue level than early or delayed protocols. Further research is necessary to confirm or decline these assumptions.…”

“…Exclusion criteria were (1) smoking habits exceeding more than 10 units a day, (2) pregnancy, (3) bone diseases or a history of irradiation, (4) ASA III or higher. Both surgical and restorative procedures were performed following a standardized protocol [ 13 , 15 ].…”

“…Therefore, the total pink aesthetic score (total-PES) ranges from 0 to 14 (total-PES 1–14 ). This method is applied in many researches [ 5 – 15 ] and generally preferred over the simplified-PES, introduced by Belser et al [ 16 ]. This latter was launched in favor of ‘ease of use and understanding’ by varying the total-PES score between 1 and 10 (total-PES 1–10 ).…”

“…To draw conclusions about the behavior of the soft tissues following IIP, pre-operative aesthetic measurements have to be taken into account. In our prospective cases series, we reported a high over-all aesthetic outcome (total-PES = 12.1) 1 year after FIIPP [ 15 ]. This analysis elucidates whether the pre-operative buccal soft tissue level (STL) or gingival phenotype influences the 1-year pink aesthetic outcome after performing FIIPP in single tooth maxillary incisor cases.…”

Linear and profilometric changes of the mucosa following soft tissue augmentation in the zone of aesthetic priority: A systematic review and meta‐analysis

“…It is not yet set whether the use of alternative techniques such as a flapless approach, palatinal/lingual implant position, filling the bone gap between the implant and buccal alveolar wall, abutment configuration and crown design might be better approaches to limit the degree of recession of the mucosa (Grunder, 2011; Kan et al., 2018; Lee et al., 2016; Lin et al., 2014; Raes et al., 2011). A prospective multicentre case series in which a flapless immediate implant placement approach was applied to 100 patients without additional SCTG reported very favourable aesthetic outcomes after 1 year (Groenendijk et al., 2020). Latter authors showed an improvement in mucosal level and a stable contour of the alveolar process the first year after treatment.…”