Facial implant gingival level and thickness changes following maxillary anterior immediate tooth replacement with scarf‐connective tissue graft: A 4–13‐year retrospective study

Kan, Joseph Y K; Yin, Shi; Rungcharassaeng, Kitichai; Zucchelli, Giovanni; Urban, Istvan A.; Lozada, Jaime

doi:10.1111/jerd.12996

Cited by 3 publications

(14 citation statements)

References 29 publications

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“…This prolonged retention time allowed for the maturation of the newly developed gingiva and especially the repositioned bone which may have minimized the orthodontically erupted tooth from relapsing. 30 The results of this study seemed to confirm this notion, as there was little to no orthodontic relapse (0.01 ± 0.17 mm) between T 1 and T 2 (34.1 months) . Furthermore, the minimal mean proximal bone level change (À0.07 ± 0.16 mm) between T 1 and T 2 also demonstrated mid-term stability of the proximal bone regeneration with orthodontic eruption.…”

Section: Discussionsupporting

confidence: 62%

“…In this study, the mean combined orthodontic eruption and retention time (14.3 months) is longer than the recommended 2 to 6 months. This prolonged retention time allowed for the maturation of the newly developed gingiva and especially the repositioned bone which may have minimized the orthodontically erupted tooth from relapsing 30 . The results of this study seemed to confirm this notion, as there was little to no orthodontic relapse (0.01 ± 0.17 mm) between T 1 and T 2 (34.1 months) .…”

Section: Discussionsupporting

confidence: 60%

“…A periodontal probe was placed at the mid-facial aspect of the sulcus epithelium, and the gingival phenotype was categorized as thin if the outline of the underlying probe could be seen through the gingiva, or as thick if the probe could not be seen through. 4,40,41…”

Section: Gingival Phenotypementioning

confidence: 99%

“…In 1993, the concept of implant site development using orthodontic forced eruption on periodontally compromised teeth for bone regeneration was first advocated 22 . Later, the term “orthodontic extraction” was introduced whereby teeth were extruded to the point of extraction, 23 followed by numerous papers validating the effectiveness of orthodontic extrusion to increase both hard and soft tissue volume 24–32 . In 2014, a diagnostic periodontal classification was proposed by evaluating the pre‐treatment anatomy indicating the hard and soft tissue response to orthodontic extrusion 33 .…”

mentioning

confidence: 99%

“…22 Later, the term "orthodontic extraction" was introduced whereby teeth were extruded to the point of extraction, 23 followed by numerous papers validating the effectiveness of orthodontic extrusion to increase both hard and soft tissue volume. [24][25][26][27][28][29][30][31][32] In 2014, a diagnostic periodontal classification was proposed by evaluating the pretreatment anatomy indicating the hard and soft tissue response to orthodontic extrusion. 33 Recently, different techniques have been described to maneuver around complications resulting from the improper use of orthodontic mechanics.…”

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confidence: 99%

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Orthodontic tooth extrusion to regenerate missing papilla adjacent to maxillary anterior single implants: A 2‐ to 7‐year retrospective study

Kan,

Rungcharassaeng,

Yin

et al. 2023

J Esthet Restor Dent

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IntroductionRegeneration of the missing papilla adjacent to single implants in the esthetic zone has always been challenging, despite advances in vertical hard and soft tissue regeneration. Orthodontic tooth extrusion has been shown to effectively gain alveolar bone and gingival tissue. This retrospective study evaluated the effectiveness of orthodontic tooth extrusion on regenerating missing papilla between existing maxillary anterior single implant and its adjacent tooth.MethodsPatients who underwent orthodontic tooth extrusion to regenerate missing papilla adjacent to a single implant in the esthetic zone were included in this study. The gingival phenotype, orthodontic extrusion movement, proximal bone level, dento‐implant papilla level, facial gingival level, mucogingival junction level, and keratinized tissue width, of the extruded tooth were recorded at pre‐orthodontic extrusion (T0), post‐orthodontic extrusion and retention (T1), and latest follow‐up (T2).ResultsA total of 17 maxillary single tooth had orthodontic tooth extrusion to regenerate missing papilla adjacent to 14 maxillary anterior single implants in 14 patients. After a mean follow‐up time of 48.4 months, implant success rate was 100% (14/14), with none of the orthodontically extruded teeth being extracted. After a mean extrusion and retention period of 14.3 months, a mean orthodontic extrusion movement of 4.62 ± 0.78 mm was noted with a mean proximal bone level gain of 3.54 ± 0.61 mm (77.0% efficacy), dento‐implant papilla level gain of 3.98 ± 0.81 mm (86.8% efficacy), and facial gingival tissue gain of 4.27 mm ± 0.55 mm (93.4% efficacy). A mean keratinized tissue width gain of 4.17 ± 0.49 mm with minimal mean mucogingival junction level change of 0.10 ± 0.30 mm were observed. The efficacy of orthodontic eruption movement on dento‐implant papilla gain was less in the thin (80.5%) phenotype group when compared with that in the thick (91.5%) phenotype group.ConclusionsWithin the confines of this study, orthodontic extrusion is an effective, noninvasive method in regenerating mid‐term stable proximal bone and papilla adjacent to maxillary anterior single implants.Clinical SignificanceThis retrospective study presents a mid‐term result on orthodontic extrusion as a mean to regenerate dento‐implant papilla defect. The extended retention period following orthodontic extrusion showed stable and efficacious proximal bone and papilla gain.

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Section: Discussionsupporting

confidence: 62%

Section: Discussionsupporting

confidence: 60%

Section: Gingival Phenotypementioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Orthodontic tooth extrusion to regenerate missing papilla adjacent to maxillary anterior single implants: A 2‐ to 7‐year retrospective study

Kan,

Rungcharassaeng,

Yin

et al. 2023

J Esthet Restor Dent

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Hard and soft tissue alterations using dual‐zone concept versus connective tissue graft at maxillary immediate implant placement: A 1‐year randomized clinical and volumetric trial

Fettouh,

Ghallab,

Mina

et al. 2024

Clinical Oral Implants Res

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ObjectivesTo evaluate the esthetic outcome, as well as clinical, radiographic, and volumetric tissue alterations 1 year after immediate implant placement (IIP) with connective tissue grafting (CTG) versus dual‐zone concept (DZ) at sites with thin labial bone in the esthetic zone.Materials and MethodsThis randomized clinical trial included 30 patients treated with IIP simultaneous with either CTG or DZ (n = 15 each). Pink esthetic score (PES) was assessed 6 months after crown placement as the primary outcome. Amount of bone labial to the implant, labio‐palatal ridge reduction, and crestal bone changes were measured via CBCT after 1 year. Volumetric analysis of linear labial soft tissue contour, interdental, and mid‐facial soft tissue level changes, and total volume loss (mm3) were measured after 1 year.ResultsSimilar PES was observed in the CTG (12.53 ± 1.13) and DZ (12.13 ± 1.55) groups, with no significant difference (p = 0.42). Likewise, there were no statistically significant differences found between the two groups in labio‐palatal bone reduction (mm&%), interdental papillae, and mid‐facial gingival levels (p > 0.05). However, the mean vertical crestal bone changes in the CTG and DZ groups were −1.1 ± 0.6 mm and 0.2 ± 1.0 mm, respectively, with a statistically significant difference (p = 0.0002). Moreover, CTG revealed less linear and total volume (mm3) loss in the labial soft tissue which was statistically significant compared to DZ (p = 0.007).ConclusionBoth groups demonstrated the same PES, nevertheless, volumetric analysis revealed twice total labial volume loss in DZ compared to CTG. It might be concluded that the use of CTG with IIP caused less horizontal reduction in the supra‐implant complex compared to the DZ.

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Single immediate implant placement in the maxillary aesthetic zone with and without connective tissue grafting: Results of a 5‐year randomized controlled trial

Zuiderveld,

Meijer,

Gareb

et al. 2024

J Clinic Periodontology

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AimTo assess the 5‐year effects of grafting connective tissue while undertaking single immediate implant placement and provisionalization at the mid‐buccal mucosa level (MBML). Secondary outcomes were buccal bone wall thickness (BBT), marginal bone level (MBL) and patient satisfaction.Materials and MethodsSixty patients with a single failing tooth in the maxillary anterior region were provided with an immediately placed and provisionalized implant. At implant placement, the patients randomly received either a connective tissue graft from the maxillary tuberosity (n = 30, test group) or no graft (n = 30, control group). The alveolar socket classification was mainly Type 2A. Data were collected before removing the failing tooth (T0), and at 1 (T1), 12 (T12) and 60 (T60) months after final crown placement. The primary outcome was the change in MBML compared with the pre‐operative situation. Additionally, the change in BBT, MBL, aesthetics (using the Pink Aesthetic Score–White Aesthetic Score), soft‐tissue peri‐implant parameters and patient satisfaction were assessed.ResultsAt the 5‐year follow‐up, 27 patients could be analysed from each group. In each group, one implant was lost during the osseointegration period, within 3 months of placement, resulting in an implant survival rate of 96.7% in both groups. MBML change at T60 was −0.6 (−1.1 to –0.1) mm in the control group and 0.1 (−0.4 to 0.5) mm in the test group (p = .008). BBT and MBL, aesthetics, soft‐tissue peri‐implant parameters and patient satisfaction showed stable results and satisfied patients, without clinically relevant differences between the groups.ConclusionsThis 5‐year follow‐up study shows that grafting connective tissue when replacing a single failing tooth with immediately placed and provisionalized implant results in favourable peri‐implant tissues and fewer MBML changes.

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Facial implant gingival level and thickness changes following maxillary anterior immediate tooth replacement with scarf‐connective tissue graft: A 4–13‐year retrospective study

Cited by 3 publications

References 29 publications

Orthodontic tooth extrusion to regenerate missing papilla adjacent to maxillary anterior single implants: A 2‐ to 7‐year retrospective study

Orthodontic tooth extrusion to regenerate missing papilla adjacent to maxillary anterior single implants: A 2‐ to 7‐year retrospective study

Hard and soft tissue alterations using dual‐zone concept versus connective tissue graft at maxillary immediate implant placement: A 1‐year randomized clinical and volumetric trial

Single immediate implant placement in the maxillary aesthetic zone with and without connective tissue grafting: Results of a 5‐year randomized controlled trial

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