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Immediate placement and provisionalization of implants in the aesthetic zone with or without a connective tissue graft: A 1-year randomized controlled trial and volumetric study


van Nimwegen, Wouter G; Raghoebar, Gerry M; Zuiderveld, Elise G; Jung, Ronald E; Meijer, Henny J A; Mühlemann, Sven (2018). Immediate placement and provisionalization of implants in the aesthetic zone with or without a connective tissue graft: A 1-year randomized controlled trial and volumetric study. Clinical Oral Implants Research, 29(7):671-678.

Abstract

OBJECTIVE
To volumetrically compare peri-implant mid-facial soft tissue changes in immediately placed and provisionalized implants in the aesthetic zone, with or without a connective tissue graft.
MATERIAL AND METHODS
Sixty patients were included. All implants were placed immediately after extraction. After randomization, in one group, a connective tissue graft (test group, n = 30) was inserted at the buccal aspect of the implant. The other group (control group, n = 30) received no connective tissue graft. Clinical parameters, digital photographs and conventional impressions were obtained before extraction (T ) and at 12 months following definitive crown placement (T ). The casts were digitized by a laboratory scanner, and a volumetric analysis was performed between T and T .
RESULTS
Twenty-five patients in each group were available for analysis at T . Volumetric change, transformed to a mean (±SD) change in thickness, was -0.68 ± 0.59 mm (test) and -0.49 ± 0.54 mm (control) with a non-significant difference between groups (p = .189). The mid-facial mucosa level was significantly different between both groups (p = .014), with a mean (±SD) change of +0.20 ± 0.70 mm (test) and -0.48 ± 1.13 mm (control). The Pink Esthetic Score was similar between both groups.
CONCLUSIONS
The use of a CTG in immediately placed and provisionalized implants in the aesthetic zone did not result in less mucosal volume loss after 12 months, leading to the assumption that a CTG cannot fully compensate for the underlying facial bone loss, although a significantly more coronally located mid-facial mucosa level was found when a CTG was performed.

Abstract

OBJECTIVE
To volumetrically compare peri-implant mid-facial soft tissue changes in immediately placed and provisionalized implants in the aesthetic zone, with or without a connective tissue graft.
MATERIAL AND METHODS
Sixty patients were included. All implants were placed immediately after extraction. After randomization, in one group, a connective tissue graft (test group, n = 30) was inserted at the buccal aspect of the implant. The other group (control group, n = 30) received no connective tissue graft. Clinical parameters, digital photographs and conventional impressions were obtained before extraction (T ) and at 12 months following definitive crown placement (T ). The casts were digitized by a laboratory scanner, and a volumetric analysis was performed between T and T .
RESULTS
Twenty-five patients in each group were available for analysis at T . Volumetric change, transformed to a mean (±SD) change in thickness, was -0.68 ± 0.59 mm (test) and -0.49 ± 0.54 mm (control) with a non-significant difference between groups (p = .189). The mid-facial mucosa level was significantly different between both groups (p = .014), with a mean (±SD) change of +0.20 ± 0.70 mm (test) and -0.48 ± 1.13 mm (control). The Pink Esthetic Score was similar between both groups.
CONCLUSIONS
The use of a CTG in immediately placed and provisionalized implants in the aesthetic zone did not result in less mucosal volume loss after 12 months, leading to the assumption that a CTG cannot fully compensate for the underlying facial bone loss, although a significantly more coronally located mid-facial mucosa level was found when a CTG was performed.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Center for Dental Medicine > Clinic of Reconstructive Dentistry
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:Oral Surgery
Language:English
Date:27 May 2018
Deposited On:04 Jul 2018 09:37
Last Modified:24 Sep 2019 23:31
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:0905-7161
OA Status:Green
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1111/clr.13258
PubMed ID:29806181

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