Influence of the fixed implant-supported provisional phase on the esthetic final outcome of implant-supported crowns: 3-year results of a randomized controlled clinical trial.

OBJECTIVES: The aim of this investigation was to evaluate whether the use of a provisional implant-supported crown improves the final esthetic outcome of implant crowns that are placed within esthetic sites. MATERIALS AND METHODS: Twenty endosseous implants were inserted in sites 13 to 23 (FDI) in 20 patients. Following the reopening procedure, a randomization process assigned them to either cohort group 1: a provisional phase with soft tissue conditioning using the "dynamic compression technique" or cohort group 2: without a provisional phase. Screw-retained all ceramic crowns were inserted. Clinical follow-up appointments were completed at 36 months evaluating clinical, radiographic outcomes, and implant success and survival. RESULTS: After 3 years, all implants survived; one implant-supported crown was excluded from the study due to adjacent tooth failure replaced with a further implant supported crown. Modified pink esthetic score (ModPES) scores were significantly different between groups 1 and 2 (P = .018); white esthetic scores (WES) were not statistically different between both groups (P = .194). Mean values of combined modPES and WES were 15.6 for group 1, with a SD of 3.20. Group 2 had a mean combined modPES and WES of 12.2, with a SD of 3.86. Mean bone loss after 3 year was -0.05 and -0.04 mm for groups 1 and 2 respectively, without being statistically significant. CONCLUSION: Fixed implant-supported provisionals improve the final esthetic outcome of the peri-implant mucosa.

Esthetic Outcome of Implant Supported Crowns With and Without Peri-Implant Conditioning Using Provisional Fixed Prosthesis: A Randomized Controlled Clinical Trial.

BACKGROUND: Achieving an optimal esthetic result using dental implants is challenging. Fixed implant-supported provisional crowns are often used to customize the emergence profile and to individualize the surrounding peri-implant soft tissue. PURPOSE: The objective of this study is to evaluate whether the use of a provisional implant-supported crown leads to an esthetic benefit on implants that are placed in the esthetic zone. The null hypothesis is that there is no-difference between the two study groups. MATERIAL AND METHODS: Twenty single implants (Bone Level, Straumann AG, Basel, Switzerland) were inserted in consecutive patients. After reopening, a randomization process assigned them to either cohort group 1: a provisional phase with soft tissue conditioning using the "dynamic compression technique" or cohort group 2: without a provisional. Implants were finally restored with an all-ceramic crown. Follow-up examinations were performed at 3 and 12 months including implant success and survival, clinical, and radiographic parameters. RESULTS: After 1 year all implants successfully integrated, mean values of combined modPES and WES were 16.7 for group 1 and 10.5 for Group 2. This was statistically significant. Mean bone loss after 1 year was -0.09 and -0.08 for groups 1 and 2, respectively, without being statistically significant. CONCLUSION: A provisional phase with soft tissue conditioning does improve the final esthetic result.

Clinical and esthetic outcomes of single-tooth implants in the anterior maxilla.

The aim of this study was to evaluate the clinical and esthetic outcomes of 10 consecutive single-tooth implant restorations in the anterior maxilla. A specific treatment protocol consisting of (1) atraumatic extraction of the failing tooth, (2) placement of an SLActive bone-level implant with simultaneous guided bone regeneration at 6 to 8 weeks postextraction, (3) loading of a provisional restoration at 2 to 3 months following implant placement, (4) production of a customized impression coping, and (5) loading of the definitive all-ceramic abutment and crown 6 months after delivery of the provisional restoration was utilized in all cases. The outcomes were assessed 1 year after loading of the definitive restoration using standard clinical parameters: pink (PES) and white esthetic scores (WES). All implants were successfully integrated, accounting for a 100% survival and success rate. Besides clinical success, the application of the specific treatment protocol may be able to provide esthetically pleasing single-tooth implant restorations in the anterior maxilla, as was demonstrated by the results for PES (7.9 ± 1.7) and WES (7.0 ± 1.5).