Evaluation of Dental Implants Placed with Different Protocols in the Maxillary Aesthetic Region

Abstract

Single tooth implant placement in the anterior maxilla has been reported to achieve predictable survival rates. Implant supported single tooth restorations in the anterior maxilla are expected to mimic their natural counterparts in order to achieve aesthetic harmony. The overall success of an implant reconstruction in the anterior maxilla must not only consider implant survival and measures of implant success, such as peri-implant tissue health, but also achieve favourable aesthetic outcomes. This has led to the development of aesthetic indices for the evaluation of the peri-implant mucosa (Pink Esthetic Score – PES) and the implant supported crown (White Esthetic Score – WES). To meet the growing needs and expectations of patients for the completion of treatment in a shorter timeframe, implant placement has been modified from a conventional delayed placement approach to abbreviated placement protocols. Although these protocols reduce the total treatment time, their outcomes are nevertheless influenced by the dynamic bone remodelling changes that occur after tooth extraction. These ridge dimensional alterations could lead to compromised outcomes, especially in the anterior maxilla, where aesthetics is of prime importance. The effect of timing of implant placement on these tissue dimensional changes has not been fully explored in the existing literature.