Immediate implant insertion und immediate provisionalization of OsseoSpeed™ implants in the presence of severe recession type defects in the esthetic zone

The retrospective analysis of this case series evaluates implant survival, hard tissue changes and soft tissue esthetics of immediately inserted and provisionalized OsseoSpeed (TM) implants in presence of severe recession type defects deeper than 3 mm in the esthetic zone. Material and Methods: In 10 patients 12 implants were inserted immediately in the esthetic zone of the maxilla. Simultaneously, a flapless grafting of the facial bone defect with autogenous bone chips and the coverage of the recession type defect with a connective tissue graft as well as an immediate provisionalization was performed. After at least 3 months the final restoration was delivered. Implant survival and success, bone level and soft tissue parameters were assessed within a follow-up period of 1 to 8 years. Results: No implant was lost in the follow-up period. The mean interproximal marginal bone level at the final examination was -0.3 mm. The height of the facial bony lamella was pre-op -7.8 mm and improved significantly to -0.3 mm. The recession was significantly reduced in mean from 5.1 to 1.7 mm. The pink esthetic score (PES) improved at all sites und increased significantly in mean from 7.2 to 11.3. The mean width of the keratinized mucosa increased significantly from 2.2 to 4.5 mm. Conclusion: The reduction of the recession, the regeneration of the facial bone level and the improved esthetic results suggest proof of principle for immediate insertion and provisionalization with bone and connective tissue grafting in the esthetic zone in presence of severe recession type defects.