Clinical and esthetic outcome with immediate insertion and provisionalization with or without connective tissue grafting in presence of mucogingival recessions: A retrospective analysis with follow‐up between 1 and 8 years

Noelken, Robert; Moergel, Maximilian; Pausch, Tobias; Kunkel, Martin; Wagner, Wilfried

doi:10.1111/cid.12595

Cited by 42 publications

(135 citation statements)

References 27 publications

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“…Similar results have been reported for other investigations of immediate implants without buccal defects [28]. A significant improvement in PES in the context of immediate implant placement has also been reported with simultaneous flapless augmentation with autogenous bone and connective tissue graft [29].…”

Section: Discussionsupporting

confidence: 89%

Gingival recession behavior with immediate implant placement in the anterior maxilla with buccal dehiscence without additional augmentation—a pilot study

et al. 2020

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Background Immediate implant placement in the presence of intact extraction alveoli has frequently been reported, while hardly any reports on immediate implant placement in missing buccal bone can be found in literature. Objectives This pilot study evaluates esthetic outcome and soft and hard tissue level changes of immediate implant placement with immediate provisionalization in patients with partially/completely missing buccal bone without any further augmentation procedure in the maxillary anterior zone. Material and methods Twelve patients (TG) with partially to completely missing buccal bone designated for extraction and flapless immediate implant insertion in the anterior zone of the maxilla were included. Patients randomly selected out of a larger group of patients with immediate implants with intact alveoli served as controls (CG). Immediate provisionalization was done without any further augmentation of the alveolar ridge. Marginal hard and soft tissue levels, PES, and implant success were evaluated during a 1-year observation period. Results The defect of the buccal alveolar bone was 4.96 mm (min., 2.26 mm; max., 9.68 mm) and the mean mesio-distal extension 4.25 mm (min., 3.2 mm; max., 5.91 mm). Preoperative PES differed significantly between TG (9.68) and CG (12.25) and improved in TG postoperatively with no significant difference to CG after 1 year (TG, 10.91; CG, 11.3). The buccal soft tissue level remained almost unchanged over the observation period (TG preop, 0.86 mm ± 0.90 mm; 1 year, 0.91 mm ± 0.96 mm; CG preop, 0.98 mm ± 0.87 mm; 1 year, 0.98 mm ± 0.87 mm and did not show any correlation with either the mesial/ distal bone level or the initial buccal vertical defect at any point of time. Conclusions These clinical results provide evidence that immediate implant placement without additional augmentation, but with immediate provisionalization might be a viable treatment alternative even with missing buccal plate in the esthetic maxillary zone.

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Section: Discussionsupporting

confidence: 89%

Gingival recession behavior with immediate implant placement in the anterior maxilla with buccal dehiscence without additional augmentation—a pilot study

et al. 2020

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“…Autogenous bone [ 46 ], a combination of autogenous bone mixed with bone xenograft [ 43 ], bone xenograft alone [ 41 , 42 , 47 ] bone xenograft with collagen membrane [ 44 ], or a mixture of allograft and xenograft [ 45 ] were used to fill the buccal gap. The implants were placed 4 mm apical to the facial gingival margin in one study [ 44 ], 3 mm apical in three studies [ 41 , 43 , 47 ],, and were placed 2 mm apical in another study [ 45 ].…”

Section: Resultsmentioning

confidence: 99%

The effect of soft tissue augmentation on the clinical and radiographical outcomes following immediate implant placement and provisionalization: a systematic review and meta-analysis

et al. 2021

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Background Nowadays, due to the esthetic and social demands of patients, conventional staged protocols seem to be increasingly replaced by faster, one-step protocols. The purpose of the present systematic review is to assess the peri-implant soft tissue changes after immediate implant placement and provisionalization (IIPP) comparing patients treated with or without a sub-epithelial connective tissue graft (SCTG) when replacing a single tooth in the esthetic region. Methods The present systematic review was written following the PRISMA checklist. Immediate implants placed with a connective tissue graft and without one were compared. The researched primary outcomes were the mid-buccal mucosa level (MBML) facial soft tissue thickness (FSTT) and marginal bone loss (MBL). The weighted mean differences (WMD) were estimated for all three outcomes. Results The change in the mid-buccal mucosa level in the intervention group was significantly higher (WMD 0.54; 95% CI 0.33–0.75), with no indication of heterogeneity (I2 = 16%). The facial soft tissue thickness increased significantly in the intervention group (WMD 0.79; 95% CI 0.37–1.22). The marginal bone loss was significantly higher in the control group (WMD 0.13; 95% CI 0.07–0.18), with no indication of heterogeneity (I2 = 0%). Conclusions The results of the meta-analyses showed a statistically significant reduced change of the marginal bone loss and vestibular recession, as well as higher soft tissue thickness, when a graft was used. The included studies had a short observation time; therefore, studies with longer follow-ups are needed to confirm these findings.

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“…The use of connective tissue graft (CTG) has been proposed with immediate implants in order to stabilize the mid‐facial gingival level and to compensate for the buccal tissue volume loss by thickening the buccal soft tissue. Although few clinical studies have focused on this issue, the evaluation methods were inconsistent (Migliorati et al., 2015; van Nimwegen et al., 2018; Noelken, Moergel, Pausch, Kunkel, & Wagner, 2018; Yoshino et al., 2014). Further research is needed to verify how and to what extent CTG can benefit IIPP, using parameters that are more objective.…”

Section: Introductionmentioning

confidence: 99%

Hard and soft tissue alterations during the healing stage of immediate implant placement and provisionalization with or without connective tissue graft: A randomized clinical trial

Jiang

Ren

et al. 2020

J Clinic Periodontology

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Clinical and esthetic outcome with immediate insertion and provisionalization with or without connective tissue grafting in presence of mucogingival recessions: A retrospective analysis with follow‐up between 1 and 8 years

Abstract: These clinical results provide evidence that immediate implant placement might improve the facial soft tissue level. This was more evident in cases with a greater recession and an additional treatment with connective tissue grafts.

Cited by 42 publications

References 27 publications

Gingival recession behavior with immediate implant placement in the anterior maxilla with buccal dehiscence without additional augmentation—a pilot study

Gingival recession behavior with immediate implant placement in the anterior maxilla with buccal dehiscence without additional augmentation—a pilot study

The effect of soft tissue augmentation on the clinical and radiographical outcomes following immediate implant placement and provisionalization: a systematic review and meta-analysis

Hard and soft tissue alterations during the healing stage of immediate implant placement and provisionalization with or without connective tissue graft: A randomized clinical trial

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