Immediate vs. Delayed Placement of Immediately Provisionalized Self-Tapping Implants: A Non-Randomized Controlled Clinical Trial with 1 Year of Follow-Up

Abstract

This study aimed to examine the clinical and esthetic outcomes of immediately provisionalized self-tapping implants placed in extraction sockets or healed edentulous ridges one year after treatment. Sixty patients in need of a single implant-supported restoration were treated with self-tapping implants (Straumann BLX) and immediate provisionalization. The implant stability quotient (ISQ) and insertion torque were recorded intraoperatively. After one year in function, the implant and prosthesis survival rate, pink esthetic score (PES), white esthetic score (WES), and marginal bone levels (MBL) were assessed. Sixty patients received 60 self-tapping implants. A total of 37 implants were placed in extraction sockets and 23 in edentulous ridges, and then all implants were immediately provisionalized. All implants achieved a high implant stability with a mean insertion torque and ISQ value of 58.1 ± 14.1 Ncm and 73.6 ± 8.1 Ncm, respectively. No significant differences were found between healed vs. post-extractive sockets (p = 0.716 and p = 0.875), or between flap vs. flapless approaches (p = 0.862 and p = 0.228) with regards to the insertion torque and ISQ value. Nonetheless, higher insertion torque values and ISQs were recorded for mandibular implants (maxilla vs. mandible, insertion torque: 55.30 + 11.25 Ncm vs. 62.41 + 17.01 Ncm, p = 0.057; ISQ: 72.05 + 8.27 vs. 76.08 + 7.37, p = 0.058). One implant did not osseointegrate, resulting in an implant survival rate of 98.3%. All implants achieved PES and WES scores higher than 12 at the 1-year follow-up. The clinical use of newly designed self-tapping implants with immediate temporization was safe and predictable. The implants achieved a good primary stability, high implant survival rate, and favorable radiographic and esthetic outcomes, regardless of the immediate or delayed placement protocols.

Implant-supported prosthetic rehabilitation after Ameloblastomas treatment: a systematic review

“…To allow immediate placement or provisionalization, good initial stability of the implant is required (> 35 N/cm2), and an implant stability coefficient value > 60 will allow a good prognosis for the patient. However, good primary stability is not always possible, and some factors such as local anatomy, bone density, implant milling protocol, and macro-design may influence it [ 93 – 95 ]. Finally, hybrid prosthetic restorations represent an excellent option for reconstructing alveolar ridges with moderate to severe resorption.…”

New Operative Protocol for Immediate Post-Extraction Implant in Lower-First-Molar Region with Rex-Blade Implants: A Case Series with 18 Months of Follow-Up

“…In such cases, potential bone resorption can lead to very serious aesthetic problems. For this reason, many authors advise against this surgical practice [6][7][8]. However, the bone resorption that occurs in the months following the extraction of a dental element has been the subject of numerous studies [6].…”

“…For this reason, many authors advise against this surgical practice [6][7][8]. However, the bone resorption that occurs in the months following the extraction of a dental element has been the subject of numerous studies [6]. There is a difference between aesthetic and non-aesthetic zones in terms of clinical recommendations.…”