Labial soft tissue contour dynamics following immediate implants and immediate provisionalization of single maxillary incisors: A 1‐year prospective study

Abstract

Background Soft tissue dynamics in the esthetic zone are gaining increasing attention in recent years. Emerging intraoral scanning technology allows easier capture of soft tissue contours. Purpose To quantitatively assess the time‐dependent contour alterations of labial soft tissue following single immediate implants and immediate provisionalization (IIPP) in maxillary incisors via intraoral scanning. Materials and Methods This was a prospective cohort study. Thirty eligible consecutive patients were included and received immediate replacement of a failure maxillary single incisor. A screw‐retained immediate restoration was delivered for each patient. Subsequently, the anterior maxillary region was scanned by an intraoral scanning system at four time points: preoperation (baseline, BL), 3 months (3 m), 6 months (6 m), and 12 months (12 m). The Standard Tessellation Language files were exported to a dedicated software and superimposed for visual analysis. At 3, 6, and 12 months, the mid‐facial mucosa level (ML) was assessed, and the precise three‐dimensional (3D) configuration of the altered volume was calculated and reconstructed for visual analysis. Furthermore, quantitative analysis of the reconstructed morphology was performed using the following parameters: mean change in thickness (△d), mesio‐distal width (w), coronal‐apical height (h), and horizontal and vertical position of the thickest point represented by coordinates (x, z). Result Twenty‐seven of thirty enrolled patients were finally available for analysis at the 1‐year follow‐up. In general, the frontal view of the reconstructed volume exhibited a crescent shape. The mid‐facial ML change at 3, 6, and 12 months was −0.05 ± 0.36 mm, −0.03 ± 0.32 mm, and −0.24 ± 0.37 mm, respectively (P = .012). The mean change in thickness at 3 months (△d3m), 6 months (△d6m), and 12 months (△d12m) was 0.50 ± 0.19 mm, 0.59 ± 0.21 mm, and 0.62 ± 0.22 mm, respectively (P <.001). At 12 months, nine patients had a △d less than 0.5 mm. The mean △d3 m/△d12 m and △d6 m/△d12 m was 0.81 ± 0.17 and 0.96 ± 0.13. The w, h, x, and z results showed no significant differences during the 1‐year observation (P = .126, P = .324, P = .635, P = .263). At 12 months, w, h, x, and z were 11.57 ± 1.77 mm, 6.46 ± 2.01 mm, 0.03 ± 1.43 mm, and 2.16 ± 0.65 mm, respectively. Conclusion During the 1‐year observation following single IIPP treatment in maxillary incisors, the labial soft tissue contour showed a continuous alteration resulting in a mean change in thickness of 0.62 mm that occurred mainly in the first 3 months and tended to be relatively stable after 6 months, while the crescent‐like shape, width, height, and thickest point position of the alteration volume remained stable after 3 months. No advanced mid‐facial recession was observed.

Contour Changes Following Immediate Placement of Ultra-Wide Implants in Molar Extraction Sockets without Bone Grafting

“…When it comes to time of implant placement, Arora and Ivanovski found a similar horizontal buccal ridge resorption for immediate (0.61 mm) and delayed (0.72 mm) implant placement [34]. Tian et al [55] reported a mean buccal horizontal reduction of 0.62 mm, 1 year after immediate implant placement and grafting of the residual jump gap combined with immediate provisionalisation. These figures are lower compared to the results of our study (0.889 mm) but can be explained by the absence of bone grafting and the difference in socket anatomy and size (molar vs anterior).…”

Soft Tissue Evaluation of an Immediate Esthetic Zone Single Implant with a Stereolithographic Guide Using 3D Reconstruction and a CAD/CAM Customized Titanium Anatomic Abutment

“…During a one-year follow-up period, the labial soft tissue contour showed a continuous alteration. The total mean change was 0.62 mm, mainly in the first three months [40]. The PES value before treatment was 11.16, and at one year of follow-up, 10.25.…”

Computer-aided three-dimensional assessment of periodontal healing distal to the mandibular second molar after coronectomy of the mandibular third molar: a prospective study

“…Digital models of mandibular bone, extraction socket (a digital model of hard tissue containing the entire extraction socket), the M2M, and root complex of the M3M after coronectomy were segmented and saved in stereolithography le format for further analyses in GeoMagic™ Studio 12 (3D Systems, Rock Hill, SC, USA) [19]. Models of mandible bone with clear anatomic markers were applied for registration according to the "Best-Fit Alignment" algorithm [25,26]. Hence, the relative migration and variation at two times (baseline and Po.6 m) could be visualized directly.…”