Background
The approach to single tooth loose in the esthetic zone is a controversial issue. The need for an optimal esthetic result and the risk of recession makes difficult the decision between immediate insertion of the implant or a delayed protocolTooth extraction and immediate implant placement followed by immediate provisional prosthesis appears to offer some advantages over conventional protocols. Not only are undoubted benefits for the patient, such as the improvement in esthetic and self-confidence from day one, but also for the clinician, as the reduction in the number of surgeries and treatment time. However, the risk of recession is an important issue to consider
Aims
The purpose of this study is to compare the tissue levels two years after crown insertion and four years later, six years after crown placement.
Methods
The 24 patients included in the study had an anterior tooth with a poor prognosis, so ideal treatment was extraction.They were treated by extraction, immediate flapless placement of an implant, and a temporary fixed prosthesis, if primary stability of implant was obtained. Impressions were taken immediately after surgery and a screwed provisional restoration was delivered within the first 24 hours.The definitive restorations were fabricated 3 months after surgery. Photographs and radiographs were taken to evaluate the changes in the gingival margin and the bone, at the time of surgery, 2 months after surgery, at the time of delivery of the definitive crown, and 1 month, 1 year and 2 years after.Patients were called for reevaluation six years after definitive crown placementThe parameters evaluated in the study were the success of implants, the vestibular gingival recession, the appropiate filing of the papilla, the gingival biotype, the bone loss, and the restorations acceptance by the patients.
Results
Between January 2010 and November 2012, 24 patients received a single immediate implant with an immediate provisional crown. They were followed for 2 years after the delivery of the final restoration.All implants were successful, basing on generally accepted criteria. The mean marginal recession measured was 0.22 mm. at the delivery of the definitive crown, 0.30 at 1 month, 0.36 at 1 year and at two years. 6 of the patients presented no recession at all, while 5 of them presented recession bigger than 0.36Of the 24 patients included in this study, 13 were determined to have a thick gingival biotype, and 11 presented a thin biotype. The recession was found to be more pronounced in implant sites with thin biotype.Three of the sites showed a dehiscence of the buccal bone wall, these cases exhibited the highest recessions.At the six-year evaluation, mean marginal recession found was 0.42. All patients with thick biotype showed no marginal recession from the second year, except for the patients with dehiscence of the buccal bone wall. The recession was also bigger in some cases were the biotype was thin.
Conclusions
Immediate placement of implants in the esthetic zone with a flapless approach and placement of a provisional fixed crown is a viable treatment alternative. The gingival recession after an observation period of six years is minimal and the periimplant tissues appear to be stable in patients with thick biotype, however, cases with thin biotype or small dehiscences of the buccal bone wall could increase the recession.
Background
The approach to single tooth loose in the esthetic zone is a controversial issue. The need for an optimal esthetic result and the risk of recession makes difficult the decision between immediate insertion of the implant or a delayed protocolTooth extraction and immediate implant placement followed by immediate provisional prosthesis appears to offer some advantages over conventional protocols. Not only are undoubted benefits for the patient, such as the improvement in esthetic and self-confidence from day one, but also for the clinician, as the reduction in the number of surgeries and treatment time. However, the risk of recession is an important issue to consider
Aims
The purpose of this study is to compare the tissue levels two years after crown insertion and four years later, six years after crown placement.
Methods
The 24 patients included in the study had an anterior tooth with a poor prognosis, so ideal treatment was extraction.They were treated by extraction, immediate flapless placement of an implant, and a temporary fixed prosthesis, if primary stability of implant was obtained. Impressions were taken immediately after surgery and a screwed provisional restoration was delivered within the first 24 hours.The definitive restorations were fabricated 3 months after surgery. Photographs and radiographs were taken to evaluate the changes in the gingival margin and the bone, at the time of surgery, 2 months after surgery, at the time of delivery of the definitive crown, and 1 month, 1 year and 2 years after.Patients were called for reevaluation six years after definitive crown placementThe parameters evaluated in the study were the success of implants, the vestibular gingival recession, the appropiate filing of the papilla, the gingival biotype, the bone loss, and the restorations acceptance by the patients.
Results
Between January 2010 and November 2012, 24 patients received a single immediate implant with an immediate provisional crown. They were followed for 2 years after the delivery of the final restoration.All implants were successful, basing on generally accepted criteria. The mean marginal recession measured was 0.22 mm. at the delivery of the definitive crown, 0.30 at 1 month, 0.36 at 1 year and at two years. 6 of the patients presented no recession at all, while 5 of them presented recession bigger than 0.36Of the 24 patients included in this study, 13 were determined to have a thick gingival biotype, and 11 presented a thin biotype. The recession was found to be more pronounced in implant sites with thin biotype.Three of the sites showed a dehiscence of the buccal bone wall, these cases exhibited the highest recessions.At the six-year evaluation, mean marginal recession found was 0.42. All patients with thick biotype showed no marginal recession from the second year, except for the patients with dehiscence of the buccal bone wall. The recession was also bigger in some cases were the biotype was thin.
Conclusions
Immediate placement of implants in the esthetic zone with a flapless approach and placement of a provisional fixed crown is a viable treatment alternative. The gingival recession after an observation period of six years is minimal and the periimplant tissues appear to be stable in patients with thick biotype, however, cases with thin biotype or small dehiscences of the buccal bone wall could increase the recession.
Background
The approach to single tooth loose in the esthetic zone is a controversial issue. The need for an optimal esthetic result and the risk of recession makes difficult the decision between immediate insertion of the implant or a delayed protocolTooth extraction and immediate implant placement followed by immediate provisional prosthesis appears to offer some advantages over conventional protocols. Not only are undoubted benefits for the patient, such as the improvement in esthetic and self-confidence from day one, but also for the clinician, as the reduction in the number of surgeries and treatment time. However, the risk of recession is an important issue to consider
Aims
The purpose of this study is to compare the tissue levels two years after crown insertion and four years later, six years after crown placement.
Methods
The 24 patients included in the study had an anterior tooth with a poor prognosis, so ideal treatment was extraction.They were treated by extraction, immediate flapless placement of an implant, and a temporary fixed prosthesis, if primary stability of implant was obtained. Impressions were taken immediately after surgery and a screwed provisional restoration was delivered within the first 24 hours.The definitive restorations were fabricated 3 months after surgery. Photographs and radiographs were taken to evaluate the changes in the gingival margin and the bone, at the time of surgery, 2 months after surgery, at the time of delivery of the definitive crown, and 1 month, 1 year and 2 years after.Patients were called for reevaluation six years after definitive crown placementThe parameters evaluated in the study were the success of implants, the vestibular gingival recession, the appropiate filing of the papilla, the gingival biotype, the bone loss, and the restorations acceptance by the patients.
Results
Between January 2010 and November 2012, 24 patients received a single immediate implant with an immediate provisional crown. They were followed for 2 years after the delivery of the final restoration.All implants were successful, basing on generally accepted criteria. The mean marginal recession measured was 0.22 mm. at the delivery of the definitive crown, 0.30 at 1 month, 0.36 at 1 year and at two years. 6 of the patients presented no recession at all, while 5 of them presented recession bigger than 0.36Of the 24 patients included in this study, 13 were determined to have a thick gingival biotype, and 11 presented a thin biotype. The recession was found to be more pronounced in implant sites with thin biotype.Three of the sites showed a dehiscence of the buccal bone wall, these cases exhibited the highest recessions.At the six-year evaluation, mean marginal recession found was 0.42. All patients with thick biotype showed no marginal recession from the second year, except for the patients with dehiscence of the buccal bone wall. The recession was also bigger in some cases were the biotype was thin.
Conclusions
Immediate placement of implants in the esthetic zone with a flapless approach and placement of a provisional fixed crown is a viable treatment alternative. The gingival recession after an observation period of six years is minimal and the periimplant tissues appear to be stable in patients with thick biotype, however, cases with thin biotype or small dehiscences of the buccal bone wall could increase the recession.
Background
The approach to single tooth loose in the esthetic zone is a controversial issue. The need for an optimal esthetic result and the risk of recession makes difficult the decision between immediate insertion of the implant or a delayed protocolTooth extraction and immediate implant placement followed by immediate provisional prosthesis appears to offer some advantages over conventional protocols. Not only are undoubted benefits for the patient, such as the improvement in esthetic and self-confidence from day one, but also for the clinician, as the reduction in the number of surgeries and treatment time. However, the risk of recession is an important issue to consider
Aims
The purpose of this study is to compare the tissue levels two years after crown insertion and four years later, six years after crown placement.
Methods
The 24 patients included in the study had an anterior tooth with a poor prognosis, so ideal treatment was extraction.They were treated by extraction, immediate flapless placement of an implant, and a temporary fixed prosthesis, if primary stability of implant was obtained. Impressions were taken immediately after surgery and a screwed provisional restoration was delivered within the first 24 hours.The definitive restorations were fabricated 3 months after surgery. Photographs and radiographs were taken to evaluate the changes in the gingival margin and the bone, at the time of surgery, 2 months after surgery, at the time of delivery of the definitive crown, and 1 month, 1 year and 2 years after.Patients were called for reevaluation six years after definitive crown placementThe parameters evaluated in the study were the success of implants, the vestibular gingival recession, the appropiate filing of the papilla, the gingival biotype, the bone loss, and the restorations acceptance by the patients.
Results
Between January 2010 and November 2012, 24 patients received a single immediate implant with an immediate provisional crown. They were followed for 2 years after the delivery of the final restoration.All implants were successful, basing on generally accepted criteria. The mean marginal recession measured was 0.22 mm. at the delivery of the definitive crown, 0.30 at 1 month, 0.36 at 1 year and at two years. 6 of the patients presented no recession at all, while 5 of them presented recession bigger than 0.36Of the 24 patients included in this study, 13 were determined to have a thick gingival biotype, and 11 presented a thin biotype. The recession was found to be more pronounced in implant sites with thin biotype.Three of the sites showed a dehiscence of the buccal bone wall, these cases exhibited the highest recessions.At the six-year evaluation, mean marginal recession found was 0.42. All patients with thick biotype showed no marginal recession from the second year, except for the patients with dehiscence of the buccal bone wall. The recession was also bigger in some cases were the biotype was thin.
Conclusions
Immediate placement of implants in the esthetic zone with a flapless approach and placement of a provisional fixed crown is a viable treatment alternative. The gingival recession after an observation period of six years is minimal and the periimplant tissues appear to be stable in patients with thick biotype, however, cases with thin biotype or small dehiscences of the buccal bone wall could increase the recession.