Guided immediate implant with and without using a mixture of autogenous and xeno bone grafts in the dental esthetic zone. A randomized clinical trial

Abstract

Purpose This in vivo study aims to assess the pink esthetic score in the anterior maxilla after computer-guided immediate implant installation and fully digital immediate temporalization with and without grafting the jumping gap with a mixture of 1:1 autogenous and xenograft particulates. Materials and methods Twenty-four patients with non-restorable upper anterior teeth in the aesthetic zone have undergone a traumatic extraction for the non-restorable tooth followed by immediate implant placement using a 3D-printed surgical guide according to prosthetically driven implant placement. The patients were divided into two groups. The study group received the dental implant after grafting the jumping gap with 1:1 autogenous and xenograft particulates, while the control group received the dental implant without grafting the jumping gap. Each patient received a digitally fabricated, immediate, nonfunctional temporary prosthesis. The esthetic outcome was compared between the two groups using the pink esthetic score at implant insertion and after 6 months of follow-up. Statistical comparisons were carried out between the studied groups using the Mann-Whitney U test. Results Immediately postoperatively, there was no statistically significant difference between the median PES in the two groups (P-value = 0.746). After six months, the study group showed a statistically significantly higher median PES than the control group (P-value = 0.048). Conclusions Grafting the jumping distance in the immediate implant protocol helps achieve a better esthetic outcome. Clinical relevance The use of immediate guided implant placement along with grafting the jumping gap followed by immediate digital temporalization guarantees a better esthetic outcome while preserving time, cost, and the number of clinical visits. Trial registration The study was registered on clinicaltrials.gov with registration number NCT04096209. (19/9/2019)

Digital design of a hybrid bone and tooth-supported surgical guide in patients with unilateral few remaining natural teeth: a dental technique

“… Make an optical scan of the remaining natural teeth either directly intraorally or indirectly by extraoral optical scanning of a conventional impression (Medit i700; Medit), then export the data in the form of a standard tessellation language (STL) file. The STL file represents the teeth surfaces and the surrounding soft tissue [ 13 ] (Fig. 2 ).…”

Immediate dental implants and major approaches: a systematic review

“…Some authors chose to leave part of the implants submerged so that they would heal conventionally (delayed loading), in case the implants with ILI failed, with the guarantee that they would not harm the final rehabilitation work. This was also important so that they could compare the two techniques in terms of results and predictability [1][2][3].…”

“…Achieving primary stability is a key factor in successfully applying immediate load in the short and long term. Different areas to be rehabilitated have different biological, anatomical, and mechanical characteristics [1,2].…”

“…The use of dental implants in the rehabilitation of partially or completely edentulous patients followed a protocol of submerging the implant for 3-6 months during osseointegration (OI) to reduce the risk of implant failure caused by movements at the interface [1,2]. In this context, subsequent improvements in surgical techniques such as implant structure and masticatory forces have led to evidence that immediate loading procedures can be successful [3].…”

“…Furthermore, smoking has been shown to have a deleterious effect on OI, but many studies have not revealed that smoking is a significant predictor for ILI. Furthermore, the results of implant surgery can be compromised by circulatory, respiratory, and hormonal diseases such as diabetes mellitus, pregnancy, alcoholism, immunodeficiency status, and vitamin Ddependent rickets [2,9].…”