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Immediate single-tooth implants in the anterior maxilla: 3-year results of a case series on hard and soft tissue response and aesthetics

Jan Cosyn UGent, ARYAN EGHBALI UGent, Hugo De Bruyn UGent, Kristiaan Collys, Roberto Cleymaet and Tim De Rouck UGent (2011) JOURNAL OF CLINICAL PERIODONTOLOGY. 38(8). p.746-753
abstract
Purpose: The objective of this prospective study was to assess the overall outcome of immediate single implant treatment in the anterior maxilla after a 3-year observation period. Material and methods: Thirty consecutively treated patients with a thick gingival biotype, ideal gingival level/contour and intact socket walls at the time of tooth extraction were treated for single-tooth replacement in the aesthetic zone by two experienced clinicians. Treatment included minimal mucoperiosteal flap elevation, immediate implant placement (Nobelreplace TiUnite®, Nobel Biocare, Göteborg, Sweden), insertion of a grafting material between the implant and the socket wall and connection of a screw-retained provisional restoration. The latter was replaced by a cemented crown 6 months thereafter. Patients were clinically and radiographically re-examined after 3 years to assess implant survival, complications and hard and soft tissue conditions. The aesthetic outcome was objectively rated using the Pink Esthetic Score (PES) and White Esthetic Scrore (WES) by a blinded clinician who had not been involved in the treatment. Results: Twenty-five patients could be re-evaluated after 3 years. One early implant failure had occurred resulting in an implant survival rate of 96 %. Radiographic examination yielded on average 1.13 mm mesial, respectively 0.86 mm distal bone loss. The clinical conditions showed fairly low peri-implant plaque (18 %) and bleeding (24 %) and mean probing depth was 3.17 mm. Mean mesial/distal papilla shrinkage and midfacial soft tissue recession in reference to the pre-operative status accounted for 0.05 mm, 0.08 mm and 0.34 mm, respectively. Between the 1- and 3-year reassessment mesial papillae showed significant re-growth (0.36 mm; p = 0.015). Advanced midfacial recession (> 1 mm) was found in 2/25 (8 %) cases. Five (21 %) cases were aesthetic failures (PES < 8 and/or WES <6) and 5/24 (21 %) showed an (almost) perfect outcome (PES ≥ 12 and WES ≥ 9). The remainder (14/24 or 58 %) demonstrated acceptable aesthetics. Conclusions: The proposed strategy seems a valuable and predictable treatment option for well-selected patients in the mid-long term as shown by almost full papillary re-growth and a low risk for advanced midfacial recession.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
immediate, Dental implant, maxilla, Pink Esthetic Score, single tooth, White Esthetic Score, GUIDED BONE REGENERATION, DENTAL IMPLANTS, PLACEMENT, PROVISIONALIZATION, RESTORATIONS, REPLACEMENTS, EXTRACTION, OUTCOMES, CROWNS, SITES
journal title
JOURNAL OF CLINICAL PERIODONTOLOGY
J. Clin. Periodontol.
volume
38
issue
8
pages
746 - 753
Web of Science type
Article
Web of Science id
000292693000009
JCR category
DENTISTRY, ORAL SURGERY & MEDICINE
JCR impact factor
2.996 (2011)
JCR rank
5/81 (2011)
JCR quartile
1 (2011)
ISSN
0303-6979
DOI
10.1111/j.1600-051X.2011.01748.x
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1267907
handle
http://hdl.handle.net/1854/LU-1267907
date created
2011-06-19 13:58:23
date last changed
2012-01-02 09:06:42
@article{1267907,
  abstract     = {Purpose: The objective of this prospective study was to assess the overall outcome of immediate single implant treatment in the anterior maxilla after a 3-year observation period.
Material and methods: Thirty consecutively treated patients with a thick gingival biotype, ideal gingival level/contour and intact socket walls at the time of tooth extraction were treated for single-tooth replacement in the aesthetic zone by two experienced clinicians. Treatment included minimal mucoperiosteal flap elevation, immediate implant placement (Nobelreplace TiUnite{\textregistered}, Nobel Biocare, G{\"o}teborg, Sweden), insertion of a grafting material between the implant and the socket wall and connection of a screw-retained provisional restoration. The latter was replaced by a cemented crown 6 months thereafter. Patients were clinically and radiographically re-examined after 3 years to assess implant survival, complications and hard and soft tissue conditions. The aesthetic outcome was objectively rated using the Pink Esthetic Score (PES) and White Esthetic Scrore (WES) by a blinded clinician who had not been involved in the treatment.
Results: Twenty-five patients could be re-evaluated after 3 years. One early implant failure had occurred resulting in an implant survival rate of 96 \%. Radiographic examination yielded on average 1.13 mm mesial, respectively 0.86 mm distal bone loss. The clinical conditions showed fairly low peri-implant plaque (18 \%) and bleeding (24 \%) and mean probing depth was 3.17 mm. Mean mesial/distal papilla shrinkage and midfacial soft tissue recession in reference to the pre-operative status accounted for 0.05 mm, 0.08 mm and 0.34 mm, respectively. Between the 1- and 3-year reassessment mesial papillae showed significant re-growth (0.36 mm; p = 0.015). Advanced midfacial recession ({\textrangle} 1 mm) was found in 2/25 (8 \%) cases. Five (21 \%) cases were aesthetic failures (PES {\textlangle} 8 and/or WES {\textlangle}6) and 5/24 (21 \%) showed an (almost) perfect outcome (PES \ensuremath{\geq} 12 and WES \ensuremath{\geq} 9). The remainder (14/24 or 58 \%) demonstrated acceptable aesthetics.
Conclusions: The proposed strategy seems a valuable and predictable treatment option for well-selected patients in the mid-long term as shown by almost full papillary re-growth and a low risk for advanced midfacial recession.},
  author       = {Cosyn, Jan and EGHBALI, ARYAN and De Bruyn, Hugo and Collys, Kristiaan and Cleymaet, Roberto and De Rouck, Tim},
  issn         = {0303-6979},
  journal      = {JOURNAL OF CLINICAL PERIODONTOLOGY},
  keyword      = {immediate,Dental implant,maxilla,Pink Esthetic Score,single tooth,White Esthetic Score,GUIDED BONE REGENERATION,DENTAL IMPLANTS,PLACEMENT,PROVISIONALIZATION,RESTORATIONS,REPLACEMENTS,EXTRACTION,OUTCOMES,CROWNS,SITES},
  language     = {eng},
  number       = {8},
  pages        = {746--753},
  title        = {Immediate single-tooth implants in the anterior maxilla: 3-year results of a case series on hard and soft tissue response and aesthetics},
  url          = {http://dx.doi.org/10.1111/j.1600-051X.2011.01748.x},
  volume       = {38},
  year         = {2011},
}

Chicago
Cosyn, Jan, ARYAN EGHBALI, Hugo De Bruyn, Kristiaan Collys, Roberto Cleymaet, and Tim De Rouck. 2011. “Immediate Single-tooth Implants in the Anterior Maxilla: 3-year Results of a Case Series on Hard and Soft Tissue Response and Aesthetics.” Journal of Clinical Periodontology 38 (8): 746–753.
APA
Cosyn, J., EGHBALI, A., De Bruyn, H., Collys, K., Cleymaet, R., & De Rouck, T. (2011). Immediate single-tooth implants in the anterior maxilla: 3-year results of a case series on hard and soft tissue response and aesthetics. JOURNAL OF CLINICAL PERIODONTOLOGY, 38(8), 746–753.
Vancouver
1.
Cosyn J, EGHBALI A, De Bruyn H, Collys K, Cleymaet R, De Rouck T. Immediate single-tooth implants in the anterior maxilla: 3-year results of a case series on hard and soft tissue response and aesthetics. JOURNAL OF CLINICAL PERIODONTOLOGY. 2011;38(8):746–53.
MLA
Cosyn, Jan, ARYAN EGHBALI, Hugo De Bruyn, et al. “Immediate Single-tooth Implants in the Anterior Maxilla: 3-year Results of a Case Series on Hard and Soft Tissue Response and Aesthetics.” JOURNAL OF CLINICAL PERIODONTOLOGY 38.8 (2011): 746–753. Print.