10-year follow-up of immediate implant placement and immediate provisionalization in the esthetic zone: A case report

Background

Immediate implant placement is an effective procedure from a functional point of view. Nevertheless, this approach is usually associated with soft-tissue recession. A careful presurgical diagnostic phase is essential in order to achieve predictable and long-lasting results. Immediate prosthetic provisionalization not only is capable on its own of shortening treatment time, but also plays an important role in conditioning the soft tissues during healing with the provisional prosthetic restoration.

Aim/Hypothesis

The presentation of a case report where one immediate and one delayed implant were placed in the same patient. Both implants were immediately restored with non- functional, provisional restorations. A 10-year follow-up of the case will be presented.

Material and Methods

A female patient, aged 19 years old, underwent orthodontic therapy, during which teeth 12 and 22 presented root resorption. Both teeth were scheduled to be extracted and replaced with dental implants. Tooth #12 was extracted at a prior date by her general dentist 6 months prior to implant placement. Tooth #22 was extracted at the day of surgery, and two implants were placed. Bovine bone substitute (Bio-Oss) was placed to cover the gap between the body of the immediately placed implant and the buccal bone. Subsequently, the implants were immediately restored with temporary crowns, taking care to avoid occlusal contacts.

Results

Final restorations were placed 4 months later, after successful osseointegration of the implants was confirmed. Clinical and radiographical examinations revealed that functional and esthetic results have withstood the test of time. No soft tissue recession was observed at the 10-year follow-up. The appropriate preoperative evaluation of the morphology of the alveolar process and the periodontal biotype, the surgical planning which provided a guide for proper implant placement, management of the peri-implant gap and the peri-implant soft tissues led to a successful result.

Conclusion and Clinical Implications

Immediate implant placement along with immediate provisional restoration in the maxillary anterior is a predictable approach with good long-term results, as long as proper treatment planning is performed.