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

Abstract

To assess the impact of implant placement and temporization timing on esthetic outcomes of single maxillary anterior implants with intact bone walls and interproximal bone. Test group patients received an immediate implant with immediate provisional restoration and socket preservation, while patients in the control group received an early implant placement with guided bone regeneration and delayed loading. Patients were followed for 1year after final prosthetic and pink esthetic score (PES), mid-buccal mucosal level (MBML), crestal bone changes (CBC), and peri-implant soft tissue parameters, and patient chair time was recorded. Fifty patients received the intended treatment (25 test and 25 control). No implants failed. PES after 1year was 12.8±1.19 for the test group and 12.5±1.36 for the control group (p=.362). MBML difference between baseline (after final crown delivery) and the 1-year follow-up was gain of 0.2±1.02mm for the test group (p=.047) and no change in the control group. CBC after 1year were 0.1mm±0.21mm (mesial) and 0.2mm±0.22mm (distal) for the test group and 0.2mm±0.25mm (mesial) and 0.3mm±0.19mm (distal) for the control group, p=.540 (mesial) and p=.462 (distal). Test group required half the chair time (127±13min) when compared to the control group (259±15min, p<.001). Within the limits of this trial, both treatment protocols resulted in excellent esthetic outcomes with PES >12 after 1-year follow-up.