Study

Immediate implant placement vs. early implant treatment in the esthetic area. A 1-year randomized clinical trial

>https://pubmed.ncbi.nlm.nih.gov/35318752/
Puisys A, Auzbikaviciute V, Vindasiute-Narbute E, Pranskunas M, Razukevicus D, Linkevicius T. Clin Oral Implants Res. 2022;33(6):634-655. doi:10.1111/clr.13924

The aim of the clinical trial was to assess the aesthetic outcomes of immediate temporization of immediately placed tapered implants in fresh extraction sockets with soft tissue and bone augmentation as compared to early placed implants with conventional loading.

Materials and methods: 

50 Patients were treated either with an immediate implant with immediate provisional restoration and socket preservation with maxgraft® granules & CTG (test group) or in the control group, early implant placement with guided bone regeneration (1:1 mix of maxgraft® granules/autologous bone and Jason® membrane) and delayed loading.

Patients were followed for 1 year after final prosthetic and pink aesthetic score (PES), mid-buccal mucosal level (MBML), crestal bone changes (CBC), and peri-implant soft tissue parameters, and patient chair time was recorded.

Results: 

Implant-related outcomes

  • No implants failures
  • Excellent aesthetic outcomes with PES >12 after 1-year follow-up in both groups

Results on soft and hard tissue

  • Mid-buccal mucosal level gain of 0.2 ± 1.02 mm for the test group (p = .047) between baseline (after final crown delivery) and the 1-year follow-up
  • Crestal bone changes after 1 year were 0.1 mm ± 0.21 mm (mesial) and 0.2 mm ± 0.22 mm (distal) for the test group and 0.2 mm ± 0.25 mm (mesial) and 0.3 mm ± 0.19 mm (distal) for the control group, p = .540 (mesial) and p = .462 (distal)

Patient related outcomes

  • Test group (immediate implantation) required half the chair time (127 ± 13 min) when compared to the control group (259 ± 15 min, p < .001)

Conclusions: 

Immediate implant with immediate provisional restoration and socket preservation (maxgraft® granules and CTG) or early implant placement with guided bone regeneration (maxgraft® granules and Jason® membrane)  and delayed loading resulted in excellent aesthetic outcomes with PES >12 after 1-year follow-up.

Immediate placement and temporization of implants had the added benefit of  reducing total chair and treatment time, reducing the number of surgical procedures per patient, and improving convenience for the patient when strict case selection criteria (single tooth gap, intact peri-implant bone walls) were met.

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