Evaluation of Immediate Implantation and Provisionalization Combined with Guided Bone Regeneration by a Flap Approach in the Maxillary Esthetic Zone: A Retrospective Controlled Study

Abstract

The aim of this research was too compare the thickness change of labial contour and bone tissues, as well as some biological complications of immediate implantation with and without immediate provisionalization for a single anterior maxilla presenting a vertical defect on labial bone with the need of guided bone regeneration (GBR) by a flap approach. A total of 40 single implants were placed in 40 patients into fresh extraction sockets of the anterior maxilla with a vertical defect on the labial bone (<4 mm). Simultaneously, GBR was conducted at the sites by a flap approach, and the implants were given immediate or delayed provisionalization. The thickness change of bone tissues during six-month evaluation and labial contour during three and six-month follow-up were measured. Complications such as implant and restoration survival rates, infection as well as wound exposure were also evaluated at six months postoperatively. After six months, the mean thickness losses in labial bone were 0.9040, 0.8050, 0.7165, 0.5285 and 0.5335 mm at five different sites in immediate provisionalization group, and 0.8780, 0.8605, 0.7560, 0.5900 and 0.6300 mm, respectively, in delayed provisionalization group, showing no significant difference between the groups at all measurement sites. Although the labial contour changes of the two groups were similar at most sites, the values at 1 and 2 mm above the implant neck remained significantly lower in the immediate provisionalization group at three and six months postoperatively. No complications occurred during the follow-up time. Based on the limitation of this study, the immediate implantation combined with GBR, flap operation and immediate provisionalization obtained acceptable outcomes for a single anterior maxilla with vertical defect on the labial bone, but more long-term research with a larger sample are urgently needed in the future.

Localized ridge augmentation with simultaneous implant placement followed by soft tissue augmentation in the maxillary anterior region: A case report

“…After 5 months, the newly formed bone was clinically evident, the implant was stable in position and CBCT revealed sufficient horizontal and vertical dimensions. A previous histological analysis revealed that xenografts can promote osteoblast proliferation in its porous structure, facilitating angiogenesis and early bone formation (27).…”

Periodontal Phenotype Modification of Peri-Implant Soft Tissue Deficiency Using Subepithelial Connective Tissue Grafts and Bone Grafts in the Esthetic Region

“…However, guided surgery can be particularly challenging in esthetic zones due to severe labial bone resorption and vertical bone loss [ 1 ]. Consequently, implants are often placed based on the available bone envelope, which may compromise the emergence profile of the prosthesis and overall aesthetics.…”