ABSTRACT
Objective @# To investigate the effect of immediate and delayed implant placement on dimensional changes in hard and soft tissues as well as esthetic outcomes. @*Methods @# A total of 40 maxillary single anterior teeth with a dehiscence defect on the labial bone (≤4 mm) were categorized into two groups according to the timing of implant placement: immediate implant placement (n = 20) or delayed implant placement (n = 20). Guided bone regeneration (GBR) was conducted at the sites using a flap approach, and the implants were given immediate provisionalization. Implant survival rates, dimensional changes in hard and soft tissues during the six- and twelve-month follow-ups, and pink esthetic scores (PESs) were measured. @*Results @# The implant survival rates in both groups were 100%, and no complications occurred during the follow-up time. There was no significant difference between the two groups at the measurement sites in the dimensional change of hard and soft tissues during the six- and twelve-month follow-ups. The largest resorption was observed at the implant neck, with a loss of (1.29 ± 0.71) mm in the immediate implant placement group and (1.43 ± 0.19) mm in the delayed implant placement group. The mean PES scores were (10.95 ± 1.51) for the immediate implant placement group and (11.05 ± 1.23) for the delayed implant placement group. @*Conclusion@# Immediate implantation or delayed implantation combined with GBR and immediate provisionalization might both be a prospective treatment strategy for a maxillary single anterior tooth with a dehiscence defect on the labial bone.
ABSTRACT
@#The method of placing an implant immediately into the fresh extraction socket at the same time as tooth extraction has the advantages of reducing the number of operations and the overall treatment time, making full use of the existing bone mass, and resulting in ideal aesthetic effects. However, immediate implant placement also has its own inherent shortcomings. Due to the existence of the extraction socket, it is difficult to close the wound; because the size of the implant does not match the size of the extraction socket, it is difficult to achieve good initial stability, and there is a risk of soft tissue recession. This article reviews the success rate, indications and expansion of immediate implant placement, surgical requirements, complications and the prevention and treatment of anterior teeth in the aesthetic area. A literature review showed that the 5-year success rate of immediate implant placement was over 95%. The indications included intact socket walls, a facial bone wall at least 1 mm in thickness, the presence of thick, soft tissue, the absence of acute infection at the site, and the availability of bone apically and lingually to the socket to provide primary stability. In addition, in recent years, with the improvement of surgical implantation technology and the improvement of bone substitute material performance, immediate implant placement can be used as one of the conventional methods for oral implantation treatment, and its indications have shown a trend toward expansion. Immediate implant placement also has complications, including poor placement of implants and gingival receding that results in poor aesthetic outcomes. In addition, immediate restoration and conventional loading protocols after immediate implant appear to have similar outcomes and result in better aesthetic effects. However, the long-term stability and patient satisfaction after immediate implant placement in terms of soft tissue aesthetics require more research.
ABSTRACT
El tratamiento con implantes dentales ha demostrado ser predecible para reemplazar los dientes perdidos o defectuosos. Este caso clínico presenta un paciente con ausencia de las coronas de los incisivos centrales superiores. Luego de una evaluación clínica y radiográfica detallada del tejido blando y óseo, se realizaron las exodoncias de las raíces de los centrales superiores sin levantamiento de un colgajo, seguido de la colocación de 2 implantes, relleno óseo y provisionalización inmediata. Al paciente se le instruyó para que llevara una dieta blanda durante 3 semanas y fue evaluado semanalmente durante un mes y luego mensualmente durante un período de cicatrización de 4 meses. Después de la estabilización del tejido blando y duro, se procedió a la colocación de las coronas definitivas con aditamentos de zirconia. Los resultados que se pueden apreciar luego de la colocación de los implantes y la provisionalización inmediata en el sector estético anterior del maxilar superior nos indican un predecible grado de éxito con esta técnica. Por lo que podemos concluir que esta técnica puede ser aplicada y recomendada siempre y cuando exista un adecuado diagnóstico y protocolo de tratamiento que brinde una correcta selección del caso y asegure una tasa de éxito similar a otras técnicas.
Treatment with dental implants has shown to be a predictable treatment to replace defective or lost teeth. A clinical case is presented on a patient with absence of the crowns of the upper central incisors. After a detailed clinical evaluation of the bone and soft tissue, a root extraction without a flap elevation was performed, followed immediately by the insertion of two implants and provisional crowns and a bone graft. The patient was instructed to follow a soft diet for 3 weeks, and was followed up weekly for a month, and then monthly for a period of 4 months. After the stabilization of the soft and hard tissues, the final crowns using zirconia abutments were inserted. The results shown after placement of the immediate dental implants and provisionalization in the anterior esthetic zone of the maxilla demonstrate a predictable grade of success with this technique. In conclusion, this technique can be applied and recommended when there is an adequate diagnosis and treatment protocol that provides a correct selection of the case in order to ensure a rate of success similar to other techniques.
Subject(s)
Humans , Male , Adult , Tooth Extraction , Dental Implants , Dental Implantation, Endosseous/methods , Dental Restoration, Temporary/methods , Esthetics, Dental , Immediate Dental Implant Loading , Incisor , Maxilla/surgery , Zirconium , Computer-Aided Design , Crowns , Dental Restoration, Temporary , Esthetics, DentalABSTRACT
A instalação de implantes em alvéolos de extração pode ser considerado um procedimento desafiador, devido ao risco de remodelação óssea e às consequentes alterações gengivais. Objetivo: o presente estudo tem como objetivo propor um protocolo de seleção do diâmetro de implantes osseointegráveis em alvéolos pós-extração na região anterossuperior, baseado na medida vestibulopalatina do alvéolo, permitindo a formação de um espaço entre o implante e a porção externa da parede óssea vestibular, de 3mm, que deverá ser preenchido com biomaterial ou com ósseo autógeno, aumentando a previsibilidade de resultados em longo prazo...
Implant placement in extraction sockets is a challenging procedure, since it offers risks of bone remodeling and, as a consequent, gingival alterations. Objective: This study aims at proposing a protocol for selecting the diameter of osseointegrated implants placed in extraction sockets in the anterosuperior region. This protocol is based on the buccal palatal dimension of the socket and allows a 3-mm gap to form between the implant and the outer surface of the buccal bone wall.Such gap must be filled with biomaterial or autograft so as to increase the predictability of long-term results...
Subject(s)
Humans , Tooth Socket/surgery , Clinical Protocols , /trends , Biocompatible Materials , Bone Remodeling , Bone Transplantation , Brazil , Tooth ExtractionABSTRACT
La perdida de un diente en la zona estética anterior y su reemplazo con una restauración implanto soportada representa uno de los mayores desafíos estéticos y funciónales en el campo de la Implantología moderna.La evidencia actual respalda la provisionalización inmediata de un implante después de su inserción con tasas de éxito comparables con las de los protocolos tradicionales utilizados recientemente. Siegenthaler y col, concluyeron que para aquellos implantes donde se alcanzó estabilidad primaria, la colocación de implantes inmediatos en alvéolos postextracción que presentaban lesiones periapicales no conllevó a un aumento en la tasa de complicaciones y resultó en una integración igualmente favorable en comparación con el grupo control. La adecuada selección del caso para este tipo de protocolos es fundamental y debe estar regido por una filosofía clara de Preservación. La preservación de las estructuras orales existentes en el área a intervenir exige un enfoque terapéutico netamente conservador que favorezca un resultado final favorable y exitoso. La paciente tratada es una de 40 años de edad que acude al postgrado de rehabilitación oral de la Universidad CES de Medellín, Colombia cuyo motivo de consulta fue "Para revisión recomendada por periodoncia" según sus propias palabras. Al momento del examen clínico intraoral se observó encía edematizada a nivel de #11 con profundad al sondaje de 10 mm en DP sospechando una fractura vertical que se corroboró con el análisis de la radiografía periapical. Se le planteó claramente a la paciente las distintas opciones de tratamiento por la pérdida del incisivo central superior con las posibles complicaciones y riesgos que se podrían presentar. La paciente aceptó la opción del implante inmediato postextracción con provisionalización y procedió a firmar el consentimiento informado de la historia clínica. Conclusiones: La provisionalización inmediata del implante brinda beneficios adicionales para la integración de los tejidos blandos, ofreciendo unos resultados estéticos de alta calidad. La colocación de implantes inmediatos en alvéolos con procesos infecciosos periapicales tiene un porcentaje de éxito prometedor a corto plazo.
The lost of an anterior tooth and it replacement with a retained implant restoration is one of the mayor functional and aesthetic challenges in modern implantogy. Actual Evidence support that immediate implant provisionalization compare with the traditional protocols have similar results in success rates. Siegenthaler y col conclude that in situations when the primary stabilization is obtained, the implant placement in fresh sockets with cronical periapical lesions have similar results versus control group. Carefull must be taken in the case selection for this modern protocol and should be done under the preservation philosophy. The integrity of remaining bone structures and soft tissue is the main goal for the success of this technique. Female patient, 40 years old, who attended the program of oral rehabilitation at the University of CES Medellin, Colombia, whose reason for consultation was "To review recommended by periodontics" in his own words. At the time of clinical examination intraoral gum edema was observed at # 11 with probing 10 mm in DP suspecting a vertical fracture who was corroborated with the analysis of the periapical X-ray. The different treatment options were stated clearly to the patient for the loss of the maxillary central incisor with the possible complications and risks that could arise. The patient agreed to the immediate post-extraction implant option with temporization and proceeded to sign the informed consent of the medical record. Conclusions: The placement of implants immediate with infectious processes periapicals has a success rate in the short term very promising. The immediate provisionalization implant provides additional benefits for the integration of soft tissues, offering some high-quality aesthetic results.
ABSTRACT
The aim of this article is to describe a chairside method for immediate implant provisionalization, which preserves the original natural emergence profile and anatomy of the teeth.
El objetivo de este artículo es describir un método directo en el sillón de provisionalización inmediata del implante, que conserva el perfil de emergencia natural original y la anatomía de los dientes.
Subject(s)
Humans , Female , Aged , Dental Prosthesis, Implant-Supported , Dental Implantation, Endosseous/methods , Dental Restoration, Temporary/methods , Esthetics, Dental , Patient Satisfaction , Time Factors , Tooth Crown , Tooth ExtractionABSTRACT
The aim of this case study was to report the clinical outcome of immediate provisionalization using one-piece narrow diameter (3.0mm) implants in missing maxillary lateral or mandibular incisors. The present study included 36 patients who were treated with 62 one-piece narrow diameter implants. After implant placement, immediate provisional restorations were delivered. All implants showed favorable osseointegration and after progressive loading from 3 months to 9 months (average of 5 months), final restorations were completed without failure in all cases. A survival rate of 100 % (62 of 62) was observed up to 23 months of observation (average of 12.6 months).
Subject(s)
Humans , Incisor , Osseointegration , Survival RateABSTRACT
STATEMENT OF PROBLEM: Interpoximal papilla could be re-established without immeidate support with a provisional resotration following an immdiate implant placement. PURPOSE: Successful esthetic outcomes were reported utilizing immediate provisionalization following immediate implant placements. The aim of this study was to evaluate the soft tissue esthetics around immediately placed single tooth implant restorations with or without immediate provisional restorations. METHODS: A total of ten patients, who had a hopeless maxillary anterior tooth, were enrolled in this study. Screw retained provisional restorations were delivered to the randomly chosen 5 patients (immediate provisionalization group) on the day of immediate implant placement and maintained for about 5 months. For the remaining five patients (non-immediate provisionalization group), healing abutments were delivered on the day of surgery, replaced with screw retained provisional restorations approximately 3 months afterwards, and the provisional restorations were maintained for about 3 months. Digital photographs were taken at the delivery of final restorations in order to assess following variables; mesial papilla, distal papilla, soft tissue level, soft tissue contour and facial soft tissue prominence. The variables were compared to those of the contralateral natural tooth and scored by prosthodontists, periodontists, orthodontists and dental students. RESULTS: The immediate provisionalization group marked significantly higher scores on the following variables; soft tissue level and facial soft tissue prominence. In evaluating each variable, there were no notable differences in opinion between four dentist groups. CONCLUSION: Immediate provisionalization can be a treatment option to achieve superior soft tissue esthetics around immediately placed single implant restorations rather than non-immediate provisionalization approaches.