Immediate Placement and Provisionalization of Maxillary Anterior Single Implants: 1-Year Prospective Study

Immediate Placement and Provisionalization of Maxillary Anterior Single Implants: 1-Year Prospective Study
September 2003
Loughlin, Robert M DDS, Department of Prosthodontics, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78284-7894
Implant Dentistry: Volume 12(3) September 2003 pp 199-200
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The purpose of this prospective study was to evaluate the implant success rate, peri-implant tissue response, and esthetic outcome of implants immediately placed and provisionalized in the anterior maxilla after a 1-year period. Thirty-five patients with a mean age of 36.5 years were selected based on specific inclusion and exclusion criteria. The inclusion criteria included an age of at least 18 years, presence of single failing maxillary anterior tooth, adequate or harmonious gingival architecture, appropriate marginal gingival to underlying bone dimension, good oral hygiene, and adequate bone volume to accommodate at least a 3.5 ?л 3.0-mm implant without grafting. The exclusion criteria included presence of active infection, complications in the medical history; history of bruxism, parafunctional habit, or lack of stable posterior occlusion; perforation of labial bony plate after extraction; and inability to achieve implant stability. Thirty-five threaded hydroxyapatite-coated tapered implants (Replace, Nobel Biocare) were placed after atraumatic extraction. A metal temporary abutment was placed and an autopolymerizing acrylic resin provisional was fabricated. The patients were prescribed antibiotics and analgesics, and were instructed to rinse with chlorhexidine. The fabrication of the final restorations was initiated 5 months after implant placement. A single examiner performed all examinations and data collection. Evaluations were made at implant placement and provisionalization and at 3, 6, and 12 months. At 12 months, all implants remained osseointegrated. The mean marginal bone change from the time of placement to 12 months was -0.26 ЈБ 0.40 mm mesially and -0.22 ЈБ 0.28 mm and distally. No significant difference in the plaque index scores was noted. From pretreatment to 12 months, the mean midfacial gingival level was -0.55 ЈБ 0.53 mm and mesial and distal papilla level changes were -0.53 ЈБ 0.39 mm and -0.39 ЈБ 0.40 mm, respectively. A mean esthetic outcome of 9.9 was recorded, and no patient had noticed any changes in the level of gingival tissues. The authors conclude that favorable implant success, peri-implant tissue responses, and esthetic outcomes can be achieved with immediately placed and provisionalized maxillary anterior single implants.