Volume assessment of the external contour around immediate implant with or without immediate tooth-like crown provisionalization: A digital intraoral scans study

PURPOSES

To examine differences between immediate and delayed dental implant loading in maxillary aesthetic areas.

METHODS

In this retrospective controlled analysis, 43 subjects who underwent immediate placement of the dental implant in a post-extraction socket were ranked into either immediate (24 implants loaded with non-occlusal tooth-like profile provisional prostheses fabricated by virtual diagnostic impressions and an in-office dental milling machine) or delayed group (19 implants loaded with conventional cover screws and secondary intention healing). Intraoperatively and then four months later, scans of the external layers were acquired with an optical scanner. The width of the alveolar crest and Jemt papilla index were acquired. Non-parametric tests were applied with a level of significance set at p < 0.01.

RESULTS

In both groups, the volumes and areas showed significant reductions from the baseline to the 4-month survey. Reductions in volume appeared to be statistically different between the two groups (-39±31 mm3 for the immediate and 89 ± 30 mm3 for the delayed group). The final Jemt papilla index appeared significantly different between the immediate (mesial, 2.5 and, distal, 3) and delayed groups (2 for both aspects).

CONCLUSIONS

Immediate provisionalization significantly reduced volume loss and area shrinkage at the external layer when data were compared to a delayed rehabilitation strategy.

Immediately provisionalized tapered conical connection implants for single-tooth restorations in the maxillary esthetic zone: a 5-year prospective single-cohort multicenter analysis

Objectives

This open, single-cohort, multicenter, prospective study investigated the efficacy of immediately provisionalized tapered conical connection implant for single-tooth restorations in the anterior and premolar regions of the maxilla after 5 years of function.

Materials and methods

All implants were placed in healed sites and immediately provisionalized. MBLs, soft-tissue parameters, and oral-health impact profile (OHIP) were evaluated at implant insertion, 6, 12, 24, 36, and 60 months. Paired Wilcoxon signed-rank tests and Kaplan–Meier survival analysis was used for statistical and implant survival/success analyses, respectively.

Results

Seventy-seven patients (81 implants) completed the 5-year follow-up. The 5-year cumulative survival and success rates were 97.8%, and the mean MBL change from implant insertion to 5 years was − 0.80 ± 1.13 mm. Optimal papilla index scores were observed at 90.1% of sites at 5 years compared with 32.8% of sites at insertion. Pink esthetic score, modified bleeding and plaque indices, and OHIP showed statistically significant improvement at the 5-year follow-up.

Conclusions

Immediately provisionalized tapered conical connection implants promote marginal bone stability and excellent esthetic outcomes after 5 years of function.

Clinical relevance

This treatment is a viable option for patients requiring immediately provisionalized single-tooth restorations in the esthetic zone and shows favorable long-term clinical outcomes, including marginal bone stability and excellent esthetics.

Retrospective cohort study of a tapered implant with high primary stability in patients with local and systemic risk factors-7-year data

Objectives

This retrospective study examined the mid- to long-term clinical and radiographic performance of a tapered implant in various treatment protocols in patients with local and systemic risk factors (RFs).

Material and methods

Two hundred seven NobelActive implants were inserted in 98 patients in the period from 10/2008 to 02/2015. The subdivision of the cohort was defined by local (n = 40), systemic (n = 6), local and systemic (n = 8), or without any RFs (n = 44) to analyze implant survival and marginal bone levels.

Results

Fifteen implants failed within the follow-up period. The mean follow-up period of the remaining implants was 34 months (range 12 to 77 months). The cumulative survival rate according to Kaplan-Meier was 91.5%. The survival rate for 93 implants in 45 patients with no RFs was 94.8% whereas it was 94% for 83 implants in 48 patients with local RFs (p = 0.618), 81.3% for 14 implants in 6 patients with systemic RFs (p = 0.173), and 76.5% for 17 implants in 6 patients with local and systemic risk factors (p = 0.006). The interproximal marginal bone level was − 0.49 ± 0.83 mm at the mesial aspect and − 0.51 ± 0.82 mm at the distal aspect in relation to implant shoulder level and showed no relevant difference in the various risk factor groups.

Conclusions

It can be assumed that the negative effects of the local or/and systemic risk factors were partially compensated by the primary stability and grade of osseointegration of the NobelActive implant.

Clinical relevance

The use of this system in patients with risk factors and immediate loading procedures.

Immediate placement and provisionalization of an implant after removal of an impacted maxillary canine: two case reports

Single immediate implant replacement is accompanied by excellent survival rates and a favorable esthetic outcome. The objective of this report was to describe a surgical approach for removal of a buccal or palatally located impacted secondary canine, combined with extraction of the failing primary canine, and immediate placement and provisionalization of an implant. A window technique was applied for surgical removal of the impacted canine. The alveolar crest was preserved. After extraction of the primary canine, the implant was inserted with primary stability. Finally, the exposed surfaces of the implant were covered with a 1:1 mixture of autologous bone and Bio-Oss®. At the 1-year evaluation, both implants were successfully osseointegrated and in function. Esthetics were excellent. It is concluded that under premise of preservation of sufficient bone to achieve primary stability of the implant, removal of the canines can be combined with immediate placement and provisionalization of the implant.