A 10‐year prospective study on single immediate implants

Abstract

Aim To evaluate the clinical, aesthetic and radiographical outcome of single immediate implant placement (IIP) after 10 years (a) and to identify putative risk factors for advanced mid‐facial recession (b). Material and Methods Periodontally healthy patients with a thick gingival biotype and intact buccal bone wall were consecutively treated with a single immediate implant and crown in the aesthetic zone (15–25). Flapless surgery and socket grafting with deproteinized bovine bone mineral were performed. Seven patients received a connective tissue graft (CTG) at 3 months due to obvious alveolar process deficiency (n = 5) or advanced mid‐facial recession (n = 2). Clinical, aesthetic and radiographical outcomes at 10 years were compared to those at 5 years and CBCTs were taken at 10 years. Results Twenty‐two patients (10 women; mean age 50) were consecutively treated and 18 could be re‐examined. Two implants failed and two patients died. None of the parameters differed between the 5‐ and 10‐year re‐assessment (marginal bone loss: 0.31 mm; plaque score: 15%; probing depth: 3.4 mm; bleeding on probing: 32%; pink aesthetic score: 10.61; mesial papillary recession: −0.03 mm; distal papillary recession: 0.22 mm; mid‐facial recession: 0.58 mm). Six implants (33%) demonstrated ≥1 mm mid‐facial recession. Putative risk factors were merely based on descriptive statistics and included buccal shoulder position, no CTG, convex emergence profile and central incisor position. Three implants (17%) had no visible buccal bone on CBCT. One of these was too buccally positioned, another yielded peri‐implant mucositis and another demonstrated peri‐implantitis. Conclusions Advanced mid‐facial recession is common in the long term following IIP. Therefore, caution is required for IIP in the aesthetic zone.

Immediate implant placement with or without connective tissue graft: A systematic review and meta‐analysis

“…Cosyn et al (2013) described a need for soft tissue grafting in one third of the patients. These patients remained stable in terms of mid‐facial soft tissue level over 10‐year follow‐up (Seyssens et al, 2020a,2020b), yet more research is needed to elucidate the true need for soft tissue grafting following IIP based on clear criteria.…”

“…Second, the observation period of included studies ranged from 12 to 36 month, which is quite short. Long‐term data are of critical importance since progressive mid‐facial recession may still occur after many years of function (Kan et al, 2011; Seyssens et al, 2020a,2020b). Finally, there is no information on the three‐dimensional implant position in any of the included studies since CBCT analyses were seldomly performed (Noelken et al, 2018).…”

“…Finally, there is no information on the three‐dimensional implant position in any of the included studies since CBCT analyses were seldomly performed (Noelken et al, 2018). This is important since buccal implant shoulder position has been associated with mid‐facial recession and is likely to occur, especially following free‐handed IIP (Benic et al, 2012; Chen & Buser, 2009, 2014; Cosyn et al, 2012b; Seyssens et al, 2020a,2020b). Since free‐handed implant installation was performed in all included studies, it is unclear in how many cases mid‐facial recession resulted from buccal implant shoulder position.…”

“…Also, satisfactory results observed during the first year of function may still be followed by progressive recession over time (Cosyn et al, 2016; Kan et al, 2011). In a recent 10‐year prospective study, even 33% of the cases demonstrated advanced mid‐facial recession (Seyssens et al, 2020a). Apart from facial bone wall dimensions, the gingival biotype seems to play a role in the extent of soft tissue collapse and the risk for mid‐facial recession around immediately installed implants (Bittner et al, 2019; Evans & Chen, 2008; Kan et al, 2011; Kinaia et al, 2017).…”

A multicenter cohort study on the association of the one‐abutment one‐time concept with marginal bone loss around bone level implants

“…MBL should be interpreted with caution following immediate implant placement as it merely reflects physiological bone formation that occurs in an extraction socket, regardless of the immediate installation of an implant. Also, when a bone replacement graft is used to fill the gap between the implant shoulder and bone wall, MBL is difficult to interpret since one is basically assessing the level of the bone replacement graft (Cosyn et al., 2019; Seyssens et al., 2020). In an RCT, Grandi et al.…”