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Immediate and conventional single implant treatment in the anterior maxilla: 1-year results of a case series on hard and soft tissue response and aesthetics

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Abstract
ABSTRACT: to document midfacial soft tissue dynamics following single immediate implant treatment (IIT) and conventional implant treatment (CIT) in the anterior maxilla when performed by experienced clinicians in well-selected patients. Material and Methods: Appropriate bone volume and ideal soft tissue levels were considered requirements for implant therapy. Additional prerequisites for IIT were intact socket walls and a thick gingival biotype. CIT included standard flap elevation whereas IIT was either performed with a flap or flapless procedure. All implants were provisionally restored using cemented acrylic crowns. Bone levels, papillae and midfacial soft tissue levels were monitored at regular intervals. The aesthetic outcome was assessed after 1 year using the pink aesthetic score (PES) and white aesthetic score (WES). Results: Sixteen patients (10 men, six women; mean age 45) received an immediate implant and 23 patients (12 men, 11 women; mean age 40) had conventional implant surgery. One immediate implant failed in the early healing phase. The mean bone level from the implant-abutment interface was 0.85 mm for IIT and 0.65 mm for CIT after 1 year (p=0.144). Mesial papillae remained stable over time. Minute loss of distal papillae occurred following IIT (-0.38 mm) and a tendency for re-growth was found following CIT (0.60 mm). Midfacial soft tissues remained stable over time following IIT with only 7% showing advanced recession (>1 mm). Flapless surgery induced less midfacial recession than flap surgery (p=0.023). Significant midfacial recession occurred following CIT (-1 mm). Overall, 24% were aesthetic failures (PES<8 and/or WES<6) and 8% showed an (almost) perfect outcome (PES12 and WES9). The remainder (68%) demonstrated acceptable aesthetics. Conclusions: Immediate implants demonstrated fairly stable midfacial soft tissue levels with only a minority of cases showing advanced recession. Irrespective of the timing of implant placement, aesthetic failures seem to be rather common and only a strict minority may show perfection.
Keywords
OUTCOMES, REPLACEMENT, RESTORATIONS, PLACEMENT, TOOTH IMPLANTS, GUIDED BONE REGENERATION, FRESH EXTRACTION SOCKETS, soft tissues, single tooth, pink aesthetic score, immediate, conventional, dental implant, CROWNS, SITES, PINK

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Chicago
Raes, Filiep, Jan Cosyn, Elisabeth Crommelinck, Peter Coessens, and Hugo De Bruyn. 2011. “Immediate and Conventional Single Implant Treatment in the Anterior Maxilla: 1-year Results of a Case Series on Hard and Soft Tissue Response and Aesthetics.” Journal of Clinical Periodontology 38 (4): 385–394.
APA
Raes, Filiep, Cosyn, J., Crommelinck, E., Coessens, P., & De Bruyn, H. (2011). Immediate and conventional single implant treatment in the anterior maxilla: 1-year results of a case series on hard and soft tissue response and aesthetics. JOURNAL OF CLINICAL PERIODONTOLOGY, 38(4), 385–394.
Vancouver
1.
Raes F, Cosyn J, Crommelinck E, Coessens P, De Bruyn H. Immediate and conventional single implant treatment in the anterior maxilla: 1-year results of a case series on hard and soft tissue response and aesthetics. JOURNAL OF CLINICAL PERIODONTOLOGY. 2011;38(4):385–94.
MLA
Raes, Filiep, Jan Cosyn, Elisabeth Crommelinck, et al. “Immediate and Conventional Single Implant Treatment in the Anterior Maxilla: 1-year Results of a Case Series on Hard and Soft Tissue Response and Aesthetics.” JOURNAL OF CLINICAL PERIODONTOLOGY 38.4 (2011): 385–394. Print.
@article{1166806,
  abstract     = {ABSTRACT: to document midfacial soft tissue dynamics following single immediate implant treatment (IIT) and conventional implant treatment (CIT) in the anterior maxilla when performed by experienced clinicians in well-selected patients. Material and Methods: Appropriate bone volume and ideal soft tissue levels were considered requirements for implant therapy. Additional prerequisites for IIT were intact socket walls and a thick gingival biotype. CIT included standard flap elevation whereas IIT was either performed with a flap or flapless procedure. All implants were provisionally restored using cemented acrylic crowns. Bone levels, papillae and midfacial soft tissue levels were monitored at regular intervals. The aesthetic outcome was assessed after 1 year using the pink aesthetic score (PES) and white aesthetic score (WES). Results: Sixteen patients (10 men, six women; mean age 45) received an immediate implant and 23 patients (12 men, 11 women; mean age 40) had conventional implant surgery. One immediate implant failed in the early healing phase. The mean bone level from the implant-abutment interface was 0.85\hspace{1em}mm for IIT and 0.65\hspace{1em}mm for CIT after 1 year (p=0.144). Mesial papillae remained stable over time. Minute loss of distal papillae occurred following IIT (-0.38\hspace{1em}mm) and a tendency for re-growth was found following CIT (0.60\hspace{1em}mm). Midfacial soft tissues remained stable over time following IIT with only 7\% showing advanced recession ({\textrangle}1\hspace{1em}mm). Flapless surgery induced less midfacial recession than flap surgery (p=0.023). Significant midfacial recession occurred following CIT (-1\hspace{1em}mm). Overall, 24\% were aesthetic failures (PES{\textlangle}8 and/or WES{\textlangle}6) and 8\% showed an (almost) perfect outcome (PES12 and WES9). The remainder (68\%) demonstrated acceptable aesthetics. Conclusions: Immediate implants demonstrated fairly stable midfacial soft tissue levels with only a minority of cases showing advanced recession. Irrespective of the timing of implant placement, aesthetic failures seem to be rather common and only a strict minority may show perfection.},
  author       = {Raes, Filiep and Cosyn, Jan and Crommelinck, Elisabeth and Coessens, Peter  and De Bruyn, Hugo},
  issn         = {0303-6979},
  journal      = {JOURNAL OF CLINICAL PERIODONTOLOGY},
  keyword      = {OUTCOMES,REPLACEMENT,RESTORATIONS,PLACEMENT,TOOTH IMPLANTS,GUIDED BONE REGENERATION,FRESH EXTRACTION SOCKETS,soft tissues,single tooth,pink aesthetic score,immediate,conventional,dental implant,CROWNS,SITES,PINK},
  language     = {eng},
  number       = {4},
  pages        = {385--394},
  title        = {Immediate and conventional single implant treatment in the anterior maxilla: 1-year results of a case series on hard and soft tissue response and aesthetics},
  url          = {http://dx.doi.org/10.1111/j.1600-051X.2010.01687.x},
  volume       = {38},
  year         = {2011},
}

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