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Systematic Review of Soft Tissue Alterations and Esthetic Outcomes Following Immediate Implant Placement and Restoration of Single Implants in the Anterior Maxilla
Author(s) -
Khzam Nabil,
Arora Himanshu,
Kim Paul,
Fisher Anthony,
Mattheos Nikos,
Ivanovski Saso
Publication year - 2015
Publication title -
journal of periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.036
H-Index - 156
eISSN - 1943-3670
pISSN - 0022-3492
DOI - 10.1902/jop.2015.150287
Subject(s) - medicine , soft tissue , gingival recession , dentistry , patient satisfaction , implant , anterior maxilla , maxilla , buccal administration , connective tissue , orthodontics , surgery , pathology
Background: The aim of this review is to assess the outcome of single‐tooth immediate implant placement and restoration (IPR) in the maxillary anterior region, with a particular emphasis on soft tissue and esthetic outcomes. Methods: An electronic search in Medline, EBSCOhost, and Ovid (PubMed) was performed to identify studies that reported on soft tissue outcomes following immediate placement and restoration of implants in the maxillary esthetic region with a mean follow‐up of ≥1 year. Results: Nineteen studies on single implants inserted immediately into fresh extraction sockets and provisionally restored in the maxillary esthetic region were included. Soft tissue changes were found to be acceptable, with most studies reporting mean gingival recession of 0.27 ± 0.38 mm and mean papillary height loss of 0.23 ± 0.27 mm after follow‐up of ≥1 year. Advanced buccal recession (>1 mm) occurred in 11% of cases. Long‐term follow‐up studies (>2 years) reported that the interdental papillae, in particular, showed a tendency to rebound over time. The few studies that reported on patient‐centered outcomes showed a high level of patient satisfaction with the outcomes of IPR treatment. Conclusions: The IPR protocol resulted in generally acceptable soft tissue and esthetic outcomes, with suboptimal results reported in ≈11% of low‐risk cases. Factors such as preoperative tissue biotype or use of a flap or connective tissue graft did not significantly influence soft tissue and esthetic outcomes. Long‐term prospective controlled clinical trials are necessary to identify factors that may influence the esthetic outcomes associated with IPR.