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

Wouter G. van Nimwegen*, Gerry M. Raghoebar, Elise G. Zuiderveld, Ronald E. Jung, Henny J. A. Meijer, Sven Muehlemann

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

ObjectiveTo 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 methodsSixty 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-pre) and at 12months following definitive crown placement (T-12). The casts were digitized by a laboratory scanner, and a volumetric analysis was performed between T-pre and T-12.

ResultsTwenty-five patients in each group were available for analysis at T-12. Volumetric change, transformed to a mean (SD) change in thickness, was -0.68 +/- 0.59mm (test) and -0.49 +/- 0.54mm (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 +/- 0.70mm (test) and -0.48 +/- 1.13mm (control). The Pink Esthetic Score was similar between both groups.

ConclusionsThe use of a CTG in immediately placed and provisionalized implants in the aesthetic zone did not result in less mucosal volume loss after 12months, 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.

Original languageEnglish
Pages (from-to)671-678
Number of pages8
JournalClinical oral implant research
Volume29
Issue number7
DOIs
Publication statusPublished - Jul-2018

Keywords

  • aesthetic zone
  • immediate placement
  • soft tissue graft
  • volumetric changes
  • OUTCOMES FOLLOWING IMMEDIATE
  • BEAM COMPUTED-TOMOGRAPHY
  • SOFT-TISSUE
  • ANTERIOR MAXILLA
  • BONE WALL
  • AUGMENTATION
  • EXTRACTION

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