Immediate implant placement and restoration in the anterior maxilla: Tissue dimensional changes after 2-5 year follow up

Abstract

Background: Immediate implant placement followed by an immediate restoration has proven tobe a viable technique in the anterior maxillary region.Purpose: This prospective study evaluated the mid-long term (2-5 years) tissue changes aroundimmediately placed and restored implants in the anterior maxilla using flapless surgery and simulta-neous hard tissue augmentation.Materials and methods: Thirty AstraTech implants were immediately placed in 30 patients, fol-lowed by the delivery of an immediate provisional restoration on the same day. All participating30 patients underwent the same treatment strategy that involved flapless removal of a failing max-illary anterior tooth, immediate implant placement, simultaneous augmentation with adeproteinized particulate xenograft, followed by the connection of a screw-retained provisionalrestoration. Radiographs and photographs were used to measure hard and soft tissue changes.Aesthetic evaluation was performed using the Pink Esthetic Score (PES).Results: All implants remained osseointegrated during the follow up period of 2-5 years (mean47 6 15 months). Twelve of the thirty patients completed the 5 year follow up. Radiographic eval-uation revealed average gains in bone levels of 0.18 and 0.34 mm mesially and distally,respectively. Soft tissue evaluation showed a mean tissue loss of 0.05 6 0.64 mm and 0.16 60.63 mm at the mesial and distal papillae, respectively, while mid-facial mucosal recession was0.29 6 0.74 mm. A significant improvement in the Pink Esthetic Scores was seen at the finalfollow-up (mean PES 11.50), as compared to the baseline (mean PES 10.27) (P 5 .001).Conclusions: In addition to a favorable implant success rate and peri-implant bony response, thesoft tissue levels and overall aesthetics around single immediately placed and restored implantscan also be maintained in the mid-long term.