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Does Timing of Implant Placement Affect Implant Therapy Outcome in the Aesthetic Zone? A Clinical, Radiological, Aesthetic, and Patient‐Based Evaluation
Author(s) -
Hof Markus,
Pommer Bernhard,
Ambros Harald,
Jesch Philip,
Vogl Susanne,
Zechner Werner
Publication year - 2015
Publication title -
clinical implant dentistry and related research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.338
H-Index - 85
eISSN - 1708-8208
pISSN - 1523-0899
DOI - 10.1111/cid.12212
Subject(s) - medicine , implant , dentistry , radiological weapon , major duodenal papilla , patient satisfaction , visual analogue scale , anterior maxilla , orthodontics , maxilla , surgery
Purpose To compare five different implant treatment protocols in the anterior maxilla, including immediate, early, and delayed implant placement, as well as implant placement in conjunction with simultaneous guided bone regeneration and implant placement 3 months following horizontal autologous bone block grafting. Material and Methods Aesthetic indices used included the P ink E sthetic S core ( PES ), P apilla I ndex ( PI ), S ubjective E sthetic S core ( SES ), and W hite E sthetic S core ( WES ). Subjective evaluation of implant aesthetics was performed using a visual analogue scale ( VAS ). The VAS consisted of a 10 cm–long line representing the degree of discontent (0%) or satisfaction (100%). Results A total of 153 implants in 153 patients (80 women, 73 men) were evaluated after a mean follow‐up of 4.5 ± 2.9 years. Mean peri‐implant bone loss was 1.6 ± 0.9 mm and not affected by treatment protocol, time after implant placement, or crown length. Papilla presence, by contrast, differed significantly between the protocols: Papilla formation was more pronounced following delayed and immediate implant placement. No statistical significance was found among treatment modalities with regard to PES , SES , or WES . Longer crowns were associated with lower PES and PI ratings and correlated with greater midfacial recession. SES was also influenced by time after implant placement and keratinized mucosa. Patient satisfaction differed significantly among treatment protocols, favoring immediate implant placement. Agreement between objective and subjective aesthetic ratings was low. Conclusion The present study suggests that comparable clinical, radiological, and aesthetic results can be achieved with all treatment protocols. Gingival recession, however, seems to occur in the long term irrespective of the technique used.