Immediate implant placement and restoration in the anterior maxilla: Tissue dimensional changes after 2-5 year follow up

BackgroundImmediate implant placement followed by an immediate restoration has proven to be a viable technique in the anterior maxillary region. PurposeThis prospective study evaluated the mid-long term (2-5 years) tissue changes around immediately placed and restored implants in the anterior maxilla using flapless surgery and simultaneous hard tissue augmentation. Materials and methodsThirty AstraTech implants were immediately placed in 30 patients, followed by the delivery of an immediate provisional restoration on the same day. All participating 30 patients underwent the same treatment strategy that involved flapless removal of a failing maxillary anterior tooth, immediate implant placement, simultaneous augmentation with a deproteinized particulate xenograft, followed by the connection of a screw-retained provisional restoration. Radiographs and photographs were used to measure hard and soft tissue changes. Aesthetic evaluation was performed using the Pink Esthetic Score (PES). ResultsAll implants remained osseointegrated during the follow up period of 2-5 years (mean 4715 months). Twelve of the thirty patients completed the 5 year follow up. Radiographic evaluation revealed average gains in bone levels of 0.18 and 0.34 mm mesially and distally, respectively. Soft tissue evaluation showed a mean tissue loss of 0.05 +/- 0.64 mm and 0.16 +/- 0.63 mm at the mesial and distal papillae, respectively, while mid-facial mucosal recession was 0.29 +/- 0.74 mm. A significant improvement in the Pink Esthetic Scores was seen at the final follow-up (mean PES 11.50), as compared to the baseline (mean PES 10.27) (P=.001). ConclusionsIn addition to a favorable implant success rate and peri-implant bony response, the soft tissue levels and overall aesthetics around single immediately placed and restored implants can also be maintained in the mid-long term.