Abstract
To evaluate the clinical, aesthetic and radiographical outcome of single immediate implant placement (IIP) after 10years (a) and to identify putative risk factors for advanced mid-facial recession (b). Periodontally healthy patients with a thick gingival biotype and intact buccal bone wall were consecutively treated with a single immediate implant and crown in the aesthetic zone (15-25). Flapless surgery and socket grafting with deproteinized bovine bone mineral were performed. Seven patients received a connective tissue graft (CTG) at 3months due to obvious alveolar process deficiency (n=5) or advanced mid-facial recession (n=2). Clinical, aesthetic and radiographical outcomes at 10years were compared to those at 5years and CBCTs were taken at 10years. Twenty-two patients (10 women; mean age 50) were consecutively treated and 18 could be re-examined. Two implants failed and two patients died. None of the parameters differed between the 5- and 10-year re-assessment (marginal bone loss: 0.31mm; plaque score: 15%; probing depth: 3.4mm; bleeding on probing: 32%; pink aesthetic score: 10.61; mesial papillary recession: -0.03mm; distal papillary recession: 0.22mm; mid-facial recession: 0.58mm). Six implants (33%) demonstrated ≥1mm mid-facial recession. Putative risk factors were merely based on descriptive statistics and included buccal shoulder position, no CTG, convex emergence profile and central incisor position. Three implants (17%) had no visible buccal bone on CBCT. One of these was too buccally positioned, another yielded peri-implant mucositis and another demonstrated peri-implantitis. Advanced mid-facial recession is common in the long term following IIP. Therefore, caution is required for IIP in the aesthetic zone.
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