The Effect of Subepithelial Connective Tissue Graft Placement on Esthetic Outcomes After Immediate Implant Placement: Systematic Review

Lee, Chun Teh; Tao, Chih Yun; Stoupel, Janet

doi:10.1902/jop.2015.150383

Cited by 38 publications

(53 citation statements)

References 46 publications

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“…() consecutive study which reported successful maintenance of the MBML with CT grafting irrespective of the initial gingival biotype after a mean follow‐up period of 2 years. It was also proposed that thickening of the mucosa could limit the degree of recession (Lee et al., ; Lin et al., ). Migliorati et al.…”

Section: Discussionmentioning

confidence: 99%

“…To limit the effects of bone remodelling on the mid‐buccal mucosa, it was proposed to place implants at least 2 mm from the internal buccal socket wall and to fill the implant‐socket gap with a bone graft (Cardaropoli, Tamagnone, Roffredo, & Gaveglio, ; Lin, Chan, & Wang, ; Merheb et al., ). Additionally, it was suggested to place a connective tissue graft (CTG) during implant placement to thicken the soft tissue (Lee, Tao, & Stoupel, ; Lin et al., ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of connective tissue grafting on peri‐implant tissue in single immediate implant sites: A RCT

Zuiderveld

Meijer

Hartog

et al. 2017

J Clinic Periodontology

280

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of connective tissue grafting on peri‐implant tissue in single immediate implant sites: A RCT

Zuiderveld

Meijer

Hartog

et al. 2017

J Clinic Periodontology

280

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“…However, Khzam et al , in a recent systematic review, failed to find a clear correlation between esthetic results and a thick biotype. In immediate implant placement, soft‐tissue augmentation seems to be less important than bone augmentation: a recent systematic review failed to find consistency regarding this topic, although a significant increase in keratinized gingiva was found . This is important as keratinized gingiva is thought to contribute toward maintaining health of peri‐implant tissues .…”

Section: Timing Of Implant Placement/regenerative Procedures/skeletalmentioning

confidence: 99%

Implant placement in the esthetic area: criteria for positioning single and multiple implants

Testori

Weinstein

Scutellà³

et al. 2018

Periodontology 2000

113

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Patient expectations from implant treatment have changed over the years and esthetics plays an important role in defining what is now called success of rehabilitation. Of the many factors that influence the outcome of the rehabilitation, the two main ones are the bone and soft-tissue deficiencies at the intended implant site. Many surgical approaches are described in terms of timing of implant placement and management of regenerative procedures. The aim of this article is to discuss the different implant placement alternatives in the esthetic area, in particular: (i) the timing of implant placement/regenerative procedures/skeletal growth/altered passive eruption; (ii) the correct three-dimensional position of the fixture between the cuspids and in the premolar area; (iii) multiple missing teeth in the esthetic area with single tooth/pontic or cantilevered options/prosthetic compensation; (iv) placement of implants into infected sites; and (v) the influence of abutment and crown morphology on implant position. Combining our long-standing clinical experience and the pertinent literature, the following conclusions can be drawn: Immediate implant placement can be a successful procedure in terms of esthetics but it is technique sensitive and requires an experienced team. Immediate placement is less traumatic to the patient as fewer surgical procedures are involved and patients tend to prefer this clinical approach with regards to quality of life. The diagnostic phase is of utmost importance, with not only bone and soft tissue deficiencies being addressed but also: skeletal growth, dental/implant soft tissue parameters such as altered passive eruption and the morphology of the roots adjacent to the edentulous area. Post-extraction immediate loading is feasible in infected sites. The correct position of the fixture should follow widely accepted guidelines but the abutment morphologies play a role in the vestibular/palatal position of the implant. The long axis of the implant, aiming at the incisal edge of the future restorations, is the most appropriate implant position when a shoulder-less abutment is used and allows a restorative crown morphology with a cervical contour resembling a natural tooth. The use of a shoulder-less abutment gives more space for the tissue to grow compared with the traditional abutment with shoulder finish line.

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“…However, these studies showed limitations regarding the small number of patients (Yoshino et al., ) and possible selection bias (Migliorati et al., ). Other studies reporting on connective tissue grafts and immediately placed and provisionalized implants mostly consist of case series and have shown inconclusive results (Lee, Tao, & Stoupel, ).…”

Section: Introductionmentioning

confidence: 99%

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

Nimwegen

Raghoebar

Zuiderveld

et al. 2018

Clinical Oral Implants Res

167

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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.

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The Effect of Subepithelial Connective Tissue Graft Placement on Esthetic Outcomes After Immediate Implant Placement: Systematic Review

Abstract: Because of the heterogeneity and limited number of selected studies, no conclusive statement could be made regarding the benefit of IMITG on esthetic outcomes. More randomized controlled trials are needed to provide definite clinical evidence.

Cited by 38 publications

References 46 publications

Effect of connective tissue grafting on peri‐implant tissue in single immediate implant sites: A RCT

Effect of connective tissue grafting on peri‐implant tissue in single immediate implant sites: A RCT

Implant placement in the esthetic area: criteria for positioning single and multiple implants

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

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