Abstract
The replacement of an unrestorable tooth with a single implant-supported prosthesis is a treatment with predictable and successful outcomes. The anterior maxilla region is a complicated site for such treatment, due to its esthetic, functional, and physiological sensitivity. The purpose of this study was to evaluate the changes in the soft tissue following an immediate implant procedure using guided surgery in combination with a computer-aided design and computer-aided manufacturing (CAD/CAM) customized titanium anatomic abutment in the esthetic zone. A total of 13 patients who had been treated with an immediate post-extraction implant placement and an immediate provisional restoration were included in the study. The changes in the soft tissue dimension, interdental papilla, and esthetic score were evaluated with a follow-up of at least one year. There was no significant change in the midfacial mucosal status when compared to the pre-treatment situation. The recession of the mesial papillary height was 0.32 mm and the distal papillary height was 0.10 mm. The mean horizontal change in the labial mucosa was 0.32 ± 0.83 mm. There was no significant difference between the mesial papilla index and the distal papilla index. The pink esthetic score value prior to treatment was 11.16, and at one-year follow-up, 10.25. Within the limitations of this study, the immediate post-extraction implant placement procedure with a stereolithographic guide and a provisionalization with a CAD/CAM customized titanium anatomic abutment may be a treatment option with predictable outcomes for the replacement of teeth in the esthetic zone.
Highlights
The replacement of an unrestorable tooth with a single implant-supported prosthesis is a treatment with predictable and successful outcomes
The purpose of this study was to evaluate the changes in the soft tissue in patients who were treated with an immediate post-extraction implant placement using a stereolithographic guide and an immediate restoration with a computer-aided design and computer-aided manufacturing (CAD/CAM) customized titanium anatomic abutment in the esthetic zone
University Dental Hospital as institutional review board (IRB) number: PNUDH-2019-017, and it included patients treated with immediately placed dental implants and an immediate provisional restoration using a titanium anatomic abutment, between April 2017 and May 2018
Summary
The replacement of an unrestorable tooth with a single implant-supported prosthesis is a treatment with predictable and successful outcomes. The buccal plate of the alveolar bone is affected, and this yields poor esthetic outcomes [5]. It is important to maintain the architecture of the fresh extraction socket for the immediate post-extraction implant placement in the esthetic zone [6,7]. Many studies have reported that an immediate implant placement and provisional restoration provide acceptable changes in the soft tissue and esthetic outcomes [8,9,10,11,12,13]. A correct fixture positioning, grafting technique, and immediate provisional restoration help achieve successful results in the esthetic zone [7,14,15,16,17,18]
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