Immediate placement and provisionalization of implants in the aesthetic zone with or without a connective tissue graft: A 1‐year randomized controlled trial and volumetric study

Abstract

ObjectiveTo volumetrically compare peri‐implant mid‐facial soft tissue changes in immediately placed and provisionalized implants in the aesthetic zone, with or without a connective tissue graft.Material and methodsSixty patients were included. All implants were placed immediately after extraction. After randomization, in one group, a connective tissue graft (test group, n = 30) was inserted at the buccal aspect of the implant. The other group (control group, n = 30) received no connective tissue graft. Clinical parameters, digital photographs and conventional impressions were obtained before extraction (T pre) and at 12 months following definitive crown placement (T 12). The casts were digitized by a laboratory scanner, and a volumetric analysis was performed between T pre and T 12.ResultsTwenty‐five patients in each group were available for analysis at T 12. Volumetric change, transformed to a mean (±SD) change in thickness, was −0.68 ± 0.59 mm (test) and −0.49 ± 0.54 mm (control) with a non‐significant difference between groups (p = .189). The mid‐facial mucosa level was significantly different between both groups (p = .014), with a mean (±SD) change of +0.20 ± 0.70 mm (test) and −0.48 ± 1.13 mm (control). The Pink Esthetic Score was similar between both groups.ConclusionsThe use of a CTG in immediately placed and provisionalized implants in the aesthetic zone did not result in less mucosal volume loss after 12 months, leading to the assumption that a CTG cannot fully compensate for the underlying facial bone loss, although a significantly more coronally located mid‐facial mucosa level was found when a CTG was performed.

Soft tissue changes after connective tissue grafts around immediately placed and restored dental implants in the esthetic zone: A systematic review and meta‐analysis

“…independently and in duplicate examined the titles and abstracts. Eleven studies were suitable for full‐text evaluation, of which, seven studies were excluded . The remaining four trials were counted in the present review (Table ).…”

A 10‐year prospective study on single immediate implants

“…Indeed, favourable anatomical factors such as a thick gingival biotype (Bittner et al., 2019; Chen, Darby, Reynolds, & Clement, 2009; Kan, Rungcharassaeng, Lozada, & Zimmerman, 2011) and a thick (>1 mm), intact buccal bone wall (Chappuis et al., 2013; Kan, Rungcharassaeng, Sclar, & Lozada, 2007) seem of major importance to prevent hard and soft tissue collapse. However, even with strict case selection and protective interventions such as connective tissue grafting (van Nimwegen et al., 2018; Zuiderveld, Meijer, den Hartog, Vissink, & Raghoebar, 2018) and immediate restoration (De Rouck, Collys, Wyn, & Cosyn, 2009) aesthetic complications may develop over time despite satisfactory initial results (Cosyn et al., 2016; Kan et al., 2011).…”

Facial alveolar bone alterations and gray value changes based on cone beam computed tomography around maxillary anterior implants: A clinical retrospective study of 1–3 years

“…Increasingly, data have suggested that gingival recession happened on the anterior maxilla within 1 year of implant placement (Atieh, Payne, Duncan, & Cullinan, 2009;Cooper et al, 2010;van Nimwegen et al, 2018). The main reason for the unfavorable outcome is the resorption of facial alveolar bone wall (Bonnet, Karouni, & Antoun, 2018;Lanza et al, 2017).…”