Immediate versus delayed implant placement in the esthetic zone: a prospective 3D volumetric assessment of peri-implant tissue stability

Abstract

Purpose To evaluate the volumetric stability of peri-implant soft and hard tissue prospectively, this study compared immediate versus delayed implants placed in the anterior esthetic region. Methods This non-randomized controlled clinical study included 25 patients, who received an immediate (type 1) or a delayed (type 4) implant placement for the replacement of a single anterior tooth. The anterior maxillae were intraorally scanned at three timepoints: before surgery (S0), 6 months (S1), and 12 months (S2) after surgery. A specific region of interest (ROI), divided into marginal and apical regions, was determined and superimposed for volumetric changes analysis. At 6 and 12 months, the probing depth (PD), bleeding/suppuration on probing (BOP/SUP), modified plaque index (PI), keratinized mucosa (KM) width, mucosal recession (MR), and implant stability (PTV) by means of periotest were recorded. Results Between S0–S2, tissue surrounding immediate implants was reduced in 0.37 ± 0.31 mm, whereas delayed implants gained 0.84 ± 0.57 mm mean tissue volume. Peri-implant tissue loss at type 1 implants occurred primarily in the marginal section of the ROI (0.42 ± 0.31 mm), whereas tissue gain at type 4 implants occurred mainly in the apical section (0.83 ± 0.51 mm). These values were significantly different between both groups for the entire ROI (p = 0.0452) and the marginal region (p = 0.0274). In addition, the mean buccal KM width around type 1 implants was significantly wider in comparison with the type 4 implants group after 12 months (p = 0.046). There were no significant differences between groups regarding PD, BOP/SUP, or PTV. Conclusions The results suggest that type 1 implants placed in the esthetic region experience more tissue loss than type 4 implants, thus marginal tissue remodeling should be considered for planning immediate implants placement in the anterior maxillae. Graphical Abstract

Implant‐supported single all‐ceramic crowns made from prefabricated (stock) or individualized CAD/CAM zirconia abutments: A 5 year randomized clinical trial

“…22 With today's technologies, soft tissue changes would more likely be detected by superimposing intraoral scans followed by direct measurement of the deviations. 23 Considering these methodological issues, the observed changes of the casts over time should not be overinterpreted.…”

“…Errors may have occurred during the standardized recording of the photos as well as during the alginate impression taking, and/or the subsequent model fabrication 22 . With today's technologies, soft tissue changes would more likely be detected by superimposing intraoral scans followed by direct measurement of the deviations 23 . Considering these methodological issues, the observed changes of the casts over time should not be overinterpreted.…”

The bone shielding versus dual‐zone concept in treating thin‐walled fresh extraction sockets with immediate implant placement: Soft and hard tissue changes. A randomized clinical trial

“…All results demonstrated herein were measured using digital three‐dimensional volumetric analysis, which offers the benefits of being comprehensive and accurate, 25 to detect the post restorative midfacial gingival recession and loss of ridge contour 26,27 . That is considered the main cornerstone in the assessment of the final esthetic outcome 28,29 .…”

Cone-Beam Computed Tomography (CBCT)-Based Assessment of the Alveolar Bone Anatomy of the Maxillary and Mandibular Molars: Implication for Immediate Implant Placement

“…Thinner bone is affected by the interruption of blood supply during the surgical procedure. Bone resorption is also reflected in soft tissue height and stability, and recession and esthetic problems are common complications after immediate implant placement [ 24 ]. In this study, most molars had a BBT of 1.5 mm or more [ 9 ].…”