Flapless immediate implant placement and provisionalization in periodontal patients: A retrospective consecutive case‐series study of single‐tooth sites with dehiscence‐type osseous defects

Abstract

Objective To assess the clinical outcomes of flapless, immediate implant placement with simultaneous augmentation of dehiscence defects and immediate provisional restoration. Materials and Methods Retrospective evaluation of 40 periodontal patients who received a flapless immediate implant for single‐tooth replacement with simultaneous augmentation of dehiscence defects and immediate provisional restoration, at follow‐up periods ranging from 1 year minimum to 7 years maximum. Dehiscence defects were augmented using autogenous bone grafts and/or deproteinized bovine bone mineral, and autogenous or allogeneic connective tissue grafts. The following aspects were evaluated: clinical success (Clinical Oral Implants Research, 8, 1997, 161), crestal bone loss (calibrated digital periapical X‐rays) and aesthetics (Pink Esthetic Score, PES). Additionally, a questionnaire was devised to obtain patient's subjective evaluation. Results A 98.3% (95% CI: 91%–99%) success rate was observed. At 8 weeks, mean bone loss was 0.47 mm (n = 39); between 8 weeks and 1 year, this va lue attained 0.24 mm and between years 1 and 5 years 0.06 mm (n = 9). The evaluated PES in 37 single‐tooth implants was 12.4, with PES = 7 (aesthetic failures) in two cases, and aesthetic outcomes were excellent (PES ≥ 12) in 29 cases (78.4%). When compared with the contralateral tooth, a recession under 1 mm was observed in 78% of cases. The patient's subjective satisfaction value ranged from 98% to 100%. Conclusion This type of minimally invasive treatment of alveoli with buccal plate deficiencies delivers, in the hands of an experienced clinician, a high clinical and aesthetic success percentage being rated by patients as satisfactory. Clinicians should be aware that 1–2 mm comparative recession could be observed.

Clinical Effect and Aesthetic Evaluation of Minimally Invasive Implant Therapy

“…Te attached gingiva closely surrounding the edge of the implant can efectively resist friction and pressure. Ticker gums mean sufcient blood supply, and can maintain an ideal biological width, which contributes to the early soft tissue sealing, healing and anti-infection of implants, and improves the initial stability [19,20]. Te follow-up of this study found that the success rate of implants in minimally invasive surgery group was not signifcantly diferent from that in conventional surgery group one year after the repair operation was completed.…”

Immediate implant placement with or without immediate provisionalization: A systematic review and meta‐analysis

“…Case selection mainly relates to buccal bone wall integrity. The body of evidence supporting type I placement in severely damaged sockets is considered weak (Tonetti et al, 2019), although clinical studies are emerging specifically evaluating IIP under these challenging conditions (Assaf et al, 2017; Sicilia‐Felechosa et al, 2020; Slagter, Meijer, et al, 2021).…”

Clinical, radiographic, and esthetic evaluation of immediate implant placement with buccal bone dehiscence in the anterior maxilla: A 1‐year prospective case series

“…This difference could be attributed to the role of soft tissue grafting in compensating for the labial tissue loss after immediate implant placement 30,31 . Additionally, our result was more favorable than that reported by Sicilia‐Felechosa and colleagues, where flapless IIP with bone grafting and connective tissue grafting was used 32 . In that study, the implant success rate was 98%.…”

“…30,31 Additionally, our result was more favorable than that reported by Sicilia-Felechosa and colleagues, where flapless IIP with bone grafting and connective tissue grafting was used. 32 In that study, the implant success rate was 98%. Esthetic failure (PES ≤ 7) was observed in two out of 40 cases and eight patients (21.6%) exhibited a 1-2 mm soft tissue recession.…”