A 10-year prospective study on single immediate implants
Corresponding Author
Lorenz Seyssens
Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
Correspondence
Lorenz Seyssens, Ghent University, Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Corneel Heymanslaan 10, B-9000 Ghent, Belgium.
Email: [email protected]
Search for more papers by this authorAryan Eghbali
Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
Search for more papers by this authorJan Cosyn
Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
Search for more papers by this authorCorresponding Author
Lorenz Seyssens
Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
Correspondence
Lorenz Seyssens, Ghent University, Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Corneel Heymanslaan 10, B-9000 Ghent, Belgium.
Email: [email protected]
Search for more papers by this authorAryan Eghbali
Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
Search for more papers by this authorJan Cosyn
Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
Search for more papers by this authorAbstract
Aim
To evaluate the clinical, aesthetic and radiographical outcome of single immediate implant placement (IIP) after 10 years (a) and to identify putative risk factors for advanced mid-facial recession (b).
Material and Methods
Periodontally healthy patients with a thick gingival biotype and intact buccal bone wall were consecutively treated with a single immediate implant and crown in the aesthetic zone (15–25). Flapless surgery and socket grafting with deproteinized bovine bone mineral were performed. Seven patients received a connective tissue graft (CTG) at 3 months due to obvious alveolar process deficiency (n = 5) or advanced mid-facial recession (n = 2). Clinical, aesthetic and radiographical outcomes at 10 years were compared to those at 5 years and CBCTs were taken at 10 years.
Results
Twenty-two patients (10 women; mean age 50) were consecutively treated and 18 could be re-examined. Two implants failed and two patients died. None of the parameters differed between the 5- and 10-year re-assessment (marginal bone loss: 0.31 mm; plaque score: 15%; probing depth: 3.4 mm; bleeding on probing: 32%; pink aesthetic score: 10.61; mesial papillary recession: −0.03 mm; distal papillary recession: 0.22 mm; mid-facial recession: 0.58 mm). Six implants (33%) demonstrated ≥1 mm mid-facial recession. Putative risk factors were merely based on descriptive statistics and included buccal shoulder position, no CTG, convex emergence profile and central incisor position. Three implants (17%) had no visible buccal bone on CBCT. One of these was too buccally positioned, another yielded peri-implant mucositis and another demonstrated peri-implantitis.
Conclusions
Advanced mid-facial recession is common in the long term following IIP. Therefore, caution is required for IIP in the aesthetic zone.
CONFLICT OF INTEREST
There are no conflicts of interest. The study was self-funded by the authors and their institutions. Nobel Biocare Belgium provided free materials to be used in the study. Prof. Cosyn has collaboration agreements with Nobel Biocare (Kloten, Switzerland) and Straumann (Basel, Switzerland).
REFERENCES
- Araujo, M. G., Sukekava, F., Wennstrom, J. L., & Lindhe, J. (2005). Ridge alterations following implant placement in fresh extraction sockets: An experimental study in the dog. Journal of Clinical Periodontology, 32, 645–652. https://doi.org/10.1111/j.1600-051X.2005.00726.x
- Benic, G. I., Mokti, M., Chen, C. J., Weber, H. P., Hammerle, C. H., & Gallucci, G. O. (2012). Dimensions of buccal bone and mucosa at immediately placed implants after 7 years: A clinical and cone beam computed tomography study. Clinical Oral Implants Research, 23, 560–566. https://doi.org/10.1111/j.1600-0501.2011.02253.x
- Bittner, N., Schulze-Spate, U., Silva, C., Da Silva, J. D., Kim, D. M., Tarnow, D., … Ishikawa-Nagai, S. (2019). Changes of the alveolar ridge dimension and gingival recession associated with implant position and tissue phenotype with immediate implant placement: A randomised controlled clinical trial. International Journal of Oral Implantology, 12, 469–480.
- Botticelli, D., Berglundh, T., & Lindhe, J. (2004). Hard-tissue alterations following immediate implant placement in extraction sites. Journal of Clinical Periodontology, 31, 820–828. https://doi.org/10.1111/j.1600-051X.2004.00565.x
- Buser, D., Martin, W., & Belser, U. C. (2004). Optimizing esthetics for implant restorations in the anterior maxilla: Anatomic and surgical considerations. International Journal of Oral and Maxillofacial Implants, 19(Suppl), 43–61.
- Chang, M., Wennstrom, J. L., Odman, P., & Andersson, B. (1999). Implant supported single-tooth replacements compared to contralateral natural teeth. Crown and soft tissue dimensions. Clinical Oral Implants Research, 10, 185–194. https://doi.org/10.1034/j.1600-0501.1999.100301.x
- Chappuis, V., Engel, O., Reyes, M., Shahim, K., Nolte, L. P., & Buser, D. (2013). Ridge alterations post-extraction in the esthetic zone: A 3D analysis with CBCT. Journal of Dental Research, 92, 195S–201S. https://doi.org/10.1177/0022034513506713
- Chen, S. T., & Buser, D. (2009). Clinical and esthetic outcomes of implants placed in postextraction sites. International Journal of Oral and Maxillofacial Implants, 24(Suppl), 186–217.
- Chen, S. T., & Buser, D. (2014). Esthetic outcomes following immediate and early implant placement in the anterior maxilla–A systematic review. International Journal of Oral and Maxillofacial Implants, 29(Suppl), 186–215. https://doi.org/10.11607/jomi.2014suppl.g3.3
- Chen, S. T., Darby, I. B., Reynolds, E. C., & Clement, J. G. (2009). Immediate implant placement postextraction without flap elevation. Journal of Periodontology, 80, 163–172. https://doi.org/10.1902/jop.2009.080243
- Clementini, M., Tiravia, L., De Risi, V., Vittorini Orgeas, G., Mannocci, A., & de Sanctis, M. (2015). Dimensional changes after immediate implant placement with or without simultaneous regenerative procedures: A systematic review and meta-analysis. Journal of Clinical Periodontology, 42, 666–677. https://doi.org/10.1111/jcpe.12423
- Cooper, L. F., Reside, G. J., Raes, F., Garriga, J. S., Tarrida, L. G., Wiltfang, J., … De Bruyn, H. (2014). Immediate provisionalization of dental implants placed in healed alveolar ridges and extraction sockets: A 5-year prospective evaluation. International Journal of Oral and Maxillofacial Implants, 29, 709–717. https://doi.org/10.11607/jomi.3617
- Cornelini, R., Cangini, F., Martuscelli, G., & Wennstrom, J. (2004). Deproteinized bovine bone and biodegradable barrier membranes to support healing following immediate placement of transmucosal implants: A short-term controlled clinical trial. International Journal of Periodontics & Restorative Dentistry, 24, 555–563.
- Cosyn, J., De Bruyn, H., & Cleymaet, R. (2013). Soft tissue preservation and pink aesthetics around single immediate implant restorations: A 1-year prospective study. Clinical Implant Dentistry and Related Research, 15, 847–857. https://doi.org/10.1111/j.1708-8208.2012.00448.x
- Cosyn, J., De Lat, L., Seyssens, L., Doornewaard, R., Deschepper, E., & Vervaeke, S. (2019). The effectiveness of immediate implant placement for single tooth replacement compared to delayed implant placement: A systematic review and meta-analysis. Journal of Clinical Periodontology, 46(Suppl 21), 224–241. https://doi.org/10.1111/jcpe.13054
- Cosyn, J., Eghbali, A., Hanselaer, L., De Rouck, T., Wyn, I., Sabzevar, M. M., … De Bruyn, H. (2013). Four modalities of single implant treatment in the anterior maxilla: A clinical, radiographic, and aesthetic evaluation. Clinical Implant Dentistry and Related Research, 15, 517–530. https://doi.org/10.1111/j.1708-8208.2011.00417.x
- Cosyn, J., Eghbali, A., Hermans, A., Vervaeke, S., De Bruyn, H., & Cleymaet, R. (2016). A 5-year prospective study on single immediate implants in the aesthetic zone. Journal of Clinical Periodontology, 43, 702–709. https://doi.org/10.1111/jcpe.12571
- Cosyn, J., Hooghe, N., & De Bruyn, H. (2012). A systematic review on the frequency of advanced recession following single immediate implant treatment. Journal of Clinical Periodontology, 39, 582–589. https://doi.org/10.1111/j.1600-051X.2012.01888.x
- Covani, U., Cornelini, R., & Barone, A. (2007). Vertical crestal bone changes around implants placed into fresh extraction sockets. Journal of Periodontology, 78, 810–815. https://doi.org/10.1902/jop.2007.060254
- Cristalli, M. P., Marini, R., La Monaca, G., Sepe, C., Tonoli, F., & Annibali, S. (2015). Immediate loading of post-extractive single-tooth implants: A 1-year prospective study. Clinical Oral Implants Research, 26, 1070–1079. https://doi.org/10.1111/clr.12403
- De Bruyckere, T., Eghbali, A., Younes, F., De Bruyn, H., & Cosyn, J. (2015). Horizontal stability of connective tissue grafts at the buccal aspect of single implants: A 1-year prospective case series. Journal of Clinical Periodontology, 42, 876–882. https://doi.org/10.1111/jcpe.12448
- De Rouck, T., Collys, K., & Cosyn, J. (2008). Immediate single-tooth implants in the anterior maxilla: A 1-year case cohort study on hard and soft tissue response. Journal of Clinical Periodontology, 35, 649–657. https://doi.org/10.1111/j.1600-051X.2008.01235.x
- De Rouck, T., Collys, K., Wyn, I., & Cosyn, J. (2009). Instant provisionalization of immediate single-tooth implants is essential to optimize esthetic treatment outcome. Clinical Oral Implants Research, 20, 566–570. https://doi.org/10.1111/j.1600-0501.2008.01674.x
- De Rouck, T., Eghbali, R., Collys, K., De Bruyn, H., & Cosyn, J. (2009). The gingival biotype revisited: Transparency of the periodontal probe through the gingival margin as a method to discriminate thin from thick gingiva. Journal of Clinical Periodontology, 36, 428–433. https://doi.org/10.1111/j.1600-051X.2009.01398.x
- Esposito, M., Grusovin, M. G., & Worthington, H. V. (2009). Agreement of quantitative subjective evaluation of esthetic changes in implant dentistry by patients and practitioners. International Journal of Oral and Maxillofacial Implants, 24, 309–315.
- Furhauser, R., Florescu, D., Benesch, T., Haas, R., Mailath, G., & Watzek, G. (2005). Evaluation of soft tissue around single-tooth implant crowns: The pink esthetic score. Clinical Oral Implants Research, 16, 639–644. https://doi.org/10.1111/j.1600-0501.2005.01193.x
- Furhauser, R., Mailath-Pokorny, G., Haas, R., Busenlechner, D., Watzek, G., & Pommer, B. (2017). Immediate restoration of immediate implants in the esthetic zone of the maxilla via the copy-abutment technique: 5-year follow-up of pink esthetic scores. Clinical Implant Dentistry and Related Research, 19, 28–37. https://doi.org/10.1111/cid.12423
- Hammerle, C. H., Chen, S. T., & Wilson, T. G. Jr (2004). Consensus statements and recommended clinical procedures regarding the placement of implants in extraction sockets. International Journal of Oral and Maxillofacial Implants, 19(Suppl), 26–28.
- Kan, J. Y., Rungcharassaeng, K., Lozada, J. L., & Zimmerman, G. (2011). Facial gingival tissue stability following immediate placement and provisionalization of maxillary anterior single implants: A 2- to 8-year follow-up. International Journal of Oral and Maxillofacial Implants, 26, 179–187.
- Kan, J. Y., Rungcharassaeng, K., Sclar, A., & Lozada, J. L. (2007). Effects of the facial osseous defect morphology on gingival dynamics after immediate tooth replacement and guided bone regeneration: 1-year results. Journal of Oral and Maxillofacial Surgery, 65, 13–19. https://doi.org/10.1016/j.joms.2007.04.006
- Khzam, N., Arora, H., Kim, P., Fisher, A., Mattheos, N., & Ivanovski, S. (2015). Systematic review of soft tissue alterations and esthetic outcomes following immediate implant placement and restoration of single implants in the anterior maxilla. Journal of Periodontology, 86, 1321–1330. https://doi.org/10.1902/jop.2015.150287
- Kinaia, B. M., Ambrosio, F., Lamble, M., Hope, K., Shah, M., & Neely, A. L. (2017). Soft tissue changes around immediately placed implants: A systematic review and meta-analyses with at least 12 months of follow-up after functional loading. Journal of Periodontology, 88, 876–886. https://doi.org/10.1902/jop.2017.160698
- Kuchler, U., Chappuis, V., Gruber, R., Lang, N. P., & Salvi, G. E. (2016). Immediate implant placement with simultaneous guided bone regeneration in the esthetic zone: 10-year clinical and radiographic outcomes. Clinical Oral Implants Research, 27, 253–257. https://doi.org/10.1111/clr.12586
- Long, L., Alqarni, H., & Masri, R. (2017). Influence of implant abutment fabrication method on clinical outcomes: A systematic review. European Journal of Oral Implantology, 10(Suppl 1), 67–77.
- Meijndert, L., Meijer, H. J., Stellingsma, K., Stegenga, B., & Raghoebar, G. M. (2007). Evaluation of aesthetics of implant-supported single-tooth replacements using different bone augmentation procedures: A prospective randomized clinical study. Clinical Oral Implants Research, 18, 715–719. https://doi.org/10.1111/j.1600-0501.2007.01415.x
- Molina, A., Sanz-Sanchez, I., Martin, C., Blanco, J., & Sanz, M. (2017). The effect of one-time abutment placement on interproximal bone levels and peri-implant soft tissues: A prospective randomized clinical trial. Clinical Oral Implants Research, 28, 443–452. https://doi.org/10.1111/clr.12818
- O'Leary, T. J., Drake, R. B., & Naylor, J. E. (1972). The plaque control record. Journal of Periodontology, 43, 38. https://doi.org/10.1902/jop.1972.43.1.38
- Raes, S., Eghbali, A., Chappuis, V., Raes, F., De Bruyn, H., & Cosyn, J. (2018). A long-term prospective cohort study on immediately restored single tooth implants inserted in extraction sockets and healed ridges: CBCT analyses, soft tissue alterations, aesthetic ratings, and patient-reported outcomes. Clinical Implant Dentistry and Related Research, 20, 522–530. https://doi.org/10.1111/cid.12613
- Renvert, S., Persson, G. R., Pirih, F. Q., & Camargo, P. M. (2018). Peri-implant health, peri-implant mucositis, and peri-implantitis: Case definitions and diagnostic considerations. Journal of Periodontology, 89(Suppl 1), S304–S312. https://doi.org/10.1002/JPER.17-0588
- Sanz, M., Lindhe, J., Alcaraz, J., Sanz-Sanchez, I., & Cecchinato, D. (2017). The effect of placing a bone replacement graft in the gap at immediately placed implants: A randomized clinical trial. Clinical Oral Implants Research, 28, 902–910. https://doi.org/10.1111/clr.12896
- Slagter, K. W., den Hartog, L., Bakker, N. A., Vissink, A., Meijer, H. J., & Raghoebar, G. M. (2014). Immediate placement of dental implants in the esthetic zone: A systematic review and pooled analysis. Journal of Periodontology, 85, e241–e250. https://doi.org/10.1902/jop.2014.130632
- Tan, W. L., Wong, T. L., Wong, M. C., & Lang, N. P. (2012). A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans. Clinical Oral Implants Research, 23(Suppl 5), 1–21. https://doi.org/10.1111/j.1600-0501.2011.02375.x
- van Nimwegen, W. G., Raghoebar, G. M., Zuiderveld, E. G., Jung, R. E., Meijer, H. J. A., & Muhlemann, S. (2018). 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. Clinical Oral Implants Research, 29, 671–678. https://doi.org/10.1111/clr.13258
- Vignoletti, F., de Sanctis, M., Berglundh, T., Abrahamsson, I., & Sanz, M. (2009). Early healing of implants placed into fresh extraction sockets: An experimental study in the beagle dog. II: Ridge alterations. Journal of Clinical Periodontology, 36, 688–697. https://doi.org/10.1111/j.1600-051X.2009.01439.x
- Younes, F., Cosyn, J., De Bruyckere, T., Cleymaet, R., Bouckaert, E., & Eghbali, A. (2018). A randomized controlled study on the accuracy of free-handed, pilot-drill guided and fully guided implant surgery in partially edentulous patients. Journal of Clinical Periodontology, 45, 721–732. https://doi.org/10.1111/jcpe.12897
- Younes, F., Eghbali, A., De Bruyckere, T., Cleymaet, R., & Cosyn, J. (2019). A randomized controlled trial on the efficiency of free-handed, pilot-drill guided and fully guided implant surgery in partially edentulous patients. Clinical Oral Implants Research, 30, 131–138. https://doi.org/10.1111/clr.13399
- Zhou, X., Yang, J., Wu, L., Tang, X., Mou, Y., Sun, W., … Xie, S. (2019). Evaluation of the effect of implants placed in preserved sockets versus fresh sockets on tissue preservation and esthetics: A meta-analysis and systematic review. Journal of Evidence Based Dental Practice, 19, 101336. https://doi.org/10.1016/j.jebdp.2019.05.015
- Zuiderveld, E. G., Meijer, H. J. A., den Hartog, L., Vissink, A., & Raghoebar, G. M. (2018). Effect of connective tissue grafting on peri-implant tissue in single immediate implant sites: A RCT. Journal of Clinical Periodontology, 45, 253–264. https://doi.org/10.1111/jcpe.12820
Citing Literature
