Influence of Immediate Implant Placement and Provisionalization with or without Soft Tissue Augmentation on Hard and Soft Tissues in the Esthetic Zone: A One-Year Retrospective Study.

Paolo De Angelis,Silvio De Angelis,Ilaria De Filippis,Antonio D’Addona,Giulio Gasparini,Margherita Giorgia Liguori,Paolo Francesco Manicone,Vincenzo Iorio Siciliano

doi:10.1155/2021/8822804

Abstract

The purpose of this clinical research was to evaluate peri-implant marginal changes around immediate implants placed either with the application of SCTG or XCM or without soft tissue grafting. A total of 48 patients requiring a single implant-supported restoration in the anterior jaw were selected for inclusion. Three surgical procedures were performed, as follows: type 1 implant with subepithelial connective tissue graft (SCTG), type 1 implant with xenogenic collagen matrix (XCM), and type 1 implant without soft tissue augmentation (NG) (control group). The marginal change of peri-implant soft tissue, facial soft tissue thickness (FSTT), peri-implant health status, esthetics, and patient satisfaction were assessed at one year after surgery. All of the placed implants showed a survival rate of 100%. No significant differences in FSTT were recorded between the SCTG group and the XCM group after treatment (P > 0.05), while the NG group presented a significant difference (P < 0.05). Patients in the NG group lost significantly more in the buccal marginal level than did patients in the SCTG group and those in the XCM group (P < 0.05). The favourable success rate recorded in all groups confirmed immediate tooth replacement as a choice of treatment for a missing anterior single tooth. The NG group presented significant changes of FSTT and buccal marginal level, while XCM constituted a viable alternative to SCTG.

Highlights

After having a tooth taken out, biological occurrences happen while the extraction socket heals, causing marked changes in the hard and soft tissue volumes [1, 2]
Teeth replacement can be performed with implants, following various clinical protocols, when there is a necessary amount of bone and when there is a favourable volume of the alveolar ridge [3, 4]
xenogenic collagen matrix (XCM) represents an alternative to autogenous connective tissue grafts (SCTG), which are the gold standard in regenerative soft tissue procedures because most soft tissue substitutes have no long-term scientific evidence

Summary

Introduction

After having a tooth taken out, biological occurrences happen while the extraction socket heals, causing marked changes in the hard and soft tissue volumes [1, 2]. Peri-implant tissue stability is a key factor that can impact the success of implant restorations because the postoperative tissue remodelling has the potential to BioMed Research International compromise the esthetic results [7, 8]. Prognostic factors are dependent on the thickness of the patient’s buccal bone wall and soft tissue phenotype [9,10,11]. The loss of teeth changes the amount of soft tissue available and it is not clear whether bone resorption can be reduced by thickening the soft tissue [14]

Methods

Results

Conclusion