Influence of Immediate Implant Placement and Provisionalization with or without Soft Tissue Augmentation on Hard and Soft Tissues in the Esthetic Zone: A One-Year Retrospective Study

Abstract

The purpose of this clinical research was to evaluate peri-implant marginal changes around immediate implants placed either with the application of SCTG or XCM or without soft tissue grafting. A total of 48 patients requiring a single implant-supported restoration in the anterior jaw were selected for inclusion. Three surgical procedures were performed, as follows: type 1 implant with subepithelial connective tissue graft (SCTG), type 1 implant with xenogenic collagen matrix (XCM), and type 1 implant without soft tissue augmentation (NG) (control group). The marginal change of peri-implant soft tissue, facial soft tissue thickness (FSTT), peri-implant health status, esthetics, and patient satisfaction were assessed at one year after surgery. All of the placed implants showed a survival rate of 100%. No significant differences in FSTT were recorded between the SCTG group and the XCM group after treatment ( P > 0.05 ), while the NG group presented a significant difference ( P < 0.05 ). Patients in the NG group lost significantly more in the buccal marginal level than did patients in the SCTG group and those in the XCM group ( P < 0.05 ). The favourable success rate recorded in all groups confirmed immediate tooth replacement as a choice of treatment for a missing anterior single tooth. The NG group presented significant changes of FSTT and buccal marginal level, while XCM constituted a viable alternative to SCTG.

The effect of soft tissue augmentation on the clinical and radiographical outcomes following immediate implant placement and provisionalization: a systematic review and meta-analysis

“…Autogenous bone [ 46 ], a combination of autogenous bone mixed with bone xenograft [ 43 ], bone xenograft alone [ 41 , 42 , 47 ] bone xenograft with collagen membrane [ 44 ], or a mixture of allograft and xenograft [ 45 ] were used to fill the buccal gap. The implants were placed 4 mm apical to the facial gingival margin in one study [ 44 ], 3 mm apical in three studies [ 41 , 43 , 47 ],, and were placed 2 mm apical in another study [ 45 ].…”

“…The provisional restorations were designed to be screw-retained in three studies [ 43 , 44 , 47 ] while one study used a cement-retained design [ 41 ] and two utilized both [ 44 , 46 ] according to the implant position. One study provided no information on the design of the provisional restoration [ 45 ].…”

“…One study provided no information on the design of the provisional restoration [ 45 ]. The provisional restoration was maintained for 6 months in two studies [ 41 , 44 ] and for 3 months in four studies [ 42 , 43 , 46 , 47 ].…”

“…Four of the selected studies were randomized controlled trials [41][42][43][44]; one was a prospective observational study [45], while the remaining two were retrospective observational studies [46,47] (Figs. 2 and 3).…”

“…Of these studies, only two [42,44] recorded all primary and secondary outcomes. Five studies recorded the MBML [41][42][43][44]46] while only four reported the FSTT [42,44,45,47], and four presented the MBL data [41][42][43][44].…”