Immediate implant placement in fresh alveolar sockets with a minimal split‐thickness envelope flap: A randomised controlled clinical trial

Abstract

Objectives Comparing PES/WES scores, modified success rate, survival, success, buccal bone thickness and patient‐reported outcomes of immediate dental implants placed in fresh alveolar sockets using a flap or a minimal split‐thickness envelope flap (MSTEF). Materials and methods Implants following random assignment into a flap or MSTEF group were placed immediately in anterior and premolar areas. Guided bone regeneration and autogenous connective tissue graft were used in all cases. A temporary prosthesis was provided followed by the final prosthesis at 16–18 weeks. Success and survival rates together with radiographic buccal bone thickness and patient satisfaction were evaluated at 12‐month post‐loading. The aesthetic outcome was evaluated through the Pink (PES) and White (WES) Aesthetic Score by 8 blind clinicians of different training background and incorporated in modified success criteria. Results 28 implants were placed on 28 patients. No statistically significant differences were noted in PES (10.54 control versus 10.80 test), WES scores (6.97 control versus 6.95 test) or success criteria including aesthetic parameters (modified success criteria) for the different specialty groups (Range 69%‐92%). In addition, no statistically significant differences were noted in survival (100%), success (100%), buccal wall thickness between control (0.72 ± 0.22) and test group (0.92 ± 0.31) and patients’ reported outcomes. Conclusions Immediate dental implant treatment with flap/ MSTEF provided similar mean PES/WES scores, modified success rate, survival, mean buccal bone levels and patients’ satisfaction. However, aesthetic failures were common in both groups.

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).…”

“…Another qualitative evaluation is based on the visual observation of PMC that is then graded using esthetic score systems (qualitative PMC evaluation and quantitative PMC reporting). A total of 93 studies (76.9%) described PMC using esthetic indices with predetermined grading scores 16–18,31–36,38,39,42–48,50–67,70–77,80–82,84–93,95–101,103,104,106–113,115–123,125,128,129,134–137,140–142 …”

“…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,…”

“…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.…”