Primary stability and PES/WES evaluation for immediate implants in the aesthetic zone: a pilot clinical double-blind randomized study

Arturo Sanchez-Perez, Ana I Nicolas-Silvente, Carmen Sanchez-Matas, Silvia Molina-García, Carlos Navarro-Cuellar, Georgios E Romanos, Arturo Sanchez-Perez, Ana I Nicolas-Silvente, Carmen Sanchez-Matas, Silvia Molina-García, Carlos Navarro-Cuellar, Georgios E Romanos

Abstract

The use of immediate implants in the aesthetic area is a technique widely used in modern implantology. The characteristics of the patient, the implant, and the surgical procedure used may influence the final results. The aim was to assess whether the implant design affects primary (P.S.) and secondary stability (S.S.), bone level (B.L.), and PES/WES evaluation. Twenty implants with two different designs (n = 10) were immediately placed and randomly located in the upper anterior maxilla with no grafting material. Implant-Stability-Quotient (ISQ), B.L., and Pink-Esthetic-Score/White-Esthetic-Score (PES/WES) were evaluated. Shapiro-Wilk normality test was performed to determine the sample normality, as the data did not follow a normal distribution, the Wilcoxon-Mann-Whitney test was applied (p < 0.05). ISQ was determined at placement (PS): control 59.1 (C.I.54.8-63.3); experimental 62.2(C.I.60.1-64.2) and three months after placement (SS): control 62.2.1 (C.I.53.3-71.0); experimental 67.2(C.I.65.8-68.5). The BL was measured at three months after placement: control 0.38 mm (C.I.- 0.06 to + 0.83); experimental 0.76 mm (C.I.0.33-1.19) and at 12 months post-loading: control 0.07 mm (C.I.- 0.50-0.65); experimental 0.90 mm (C.I.0.38-1.42). PES/WES values were evaluated for the control group: 15 (C.I.12.68-17.32), and for the experimental group 15.20 (C.I.11.99-18.41). No significant differences were shown between both implant designs. A good grade of osseointegration and primary/secondary stability was achieved, as well as proper maintenance of crestal bone and adequate PES/WES scores. The criteria for selection for the ideal patient for immediate implant placement is essential.ClinicalTrials Protocol ID: NCT04343833.

Conflict of interest statement

The authors declare no competing interests.

© 2021. The Author(s).

Figures

Figure 1
Figure 1
Implant design (a) Design for the control group (Inhex Ticare Standard, Mozo Grau, Ticare, Valladolid, Spain); (b) Design for the experimental group (Inhex Quattro Ticare, Mozo Grau, Ticare, Valladolid, Spain).
Figure 2
Figure 2
Protocol for randomized distribution of the sample. Distribution of the sample and the final number of dropouts and samples with completion of the study.
Figure 3
Figure 3
Scheme of the follow-up protocol for treated patients.
Figure 4
Figure 4
PES/WES Evaluation. (a) Parameters evaluated by WES and (b) parameters evaluated by PES.
Figure 5
Figure 5
Mean and C.I. of ISQ values for the control group and experimental group during implant insertion (primary stability) and at three months after implant insertion (secondary stability).
Figure 6
Figure 6
Mean and C.I. for BL values for the control group and experimental group at three months after implant placement and at twelve months after loading.

References

    1. Schulte W, Heimke G. The Tübinger immediate implant. Quintessenz. 1976;27:17–23.
    1. Lazzara RJ. Immediate implant placement into extraction sites: Surgical and restorative advantages. Int. J. Periodontics Restorative Dent. 1989;9:332–343.
    1. Werbitt MJ, Goldberg PV. The Immediate Implant: Bone preservation and bone regeneration. Int. J. Periodontics Restorative Dent. 1992;12:206–217.
    1. Lindeboom JAH, Tjiook Y, Kroon FHM. Immediate placement of implants in periapical infected sites: A prospective randomized study in 50 patients. Oral Surg. Oral Med Oral Pathol. Oral Radiol. Endodontol. 2006;101:705–710. doi: 10.1016/j.tripleo.2005.08.022.
    1. Maló P, Rangert B, Dvärsäter L. Immediate function of brånemark implants in the esthetic zone: A retrospective clinical study with 6 months to 4 years of follow-up. Clin. Implant Dent. Relat. Res. 2000;2:138–146. doi: 10.1111/j.1708-8208.2000.tb00004.x.
    1. De Bruyn H, Collaert B. Early loading of machined-surface brånemark implants in completely edentulous mandibles: Healed bone versus fresh extraction sites. Clin. Implant Dent. Relat. Res. 2002;4:136–142. doi: 10.1111/j.1708-8208.2002.tb00164.x.
    1. Kourtis SG, Sotiriado S, Voliotis S, Challas A. Private practice results of dental implants. Part I: Survival and evaluation of risk factors—Part II: Surgical and prosthetic complications. Implant Dent. 2004;13:373–385. doi: 10.1097/.
    1. Dhanrajani PJ, Al-Rafee MA. Single-tooth implant restorations: A retrospective study. Implant Dent. 2005;14:125–130. doi: 10.1097/01.id.0000163806.14351.54.
    1. Horwitz J, Zuabi O, Peled M, Machtei EE. Immediate and delayed restoration of dental implants in periodontally susceptible patients: 1-year results. Int. J. Oral Maxillofac. Implant. 2007;22:423–429.
    1. Deng F, et al. Comparison of clinical outcomes for implants placed in fresh extraction sockets versus healed sites in periodontally compromised patients: A 1-year follow-up report. Int. J. Oral Maxillofac. Implants. 2010;25:1036–1040.
    1. Ji TJ, Kan JYK, Rungcharassaeng K, Roe P, Lozada JL. Immediate loading of maxillary and mandibular implant-supported fixed complete dentures: A 1- to 10-year retrospective study. J. Oral Implantol. 2012;38:469–476. doi: 10.1563/AAID-JOI-D-11-00027.
    1. Wöhrle PS. Single-tooth replacement in the aesthetic zone with immediate provisionalization: Fourteen consecutive case reports. Pract. Periodontics Aesthet. Dent. 1998;10:1107–1114.
    1. Kan JY, Rungcharassaeng K, Ojano M, Goodacre CJ. Flapless anterior implant surgery: A surgical and prosthodontic rationale. Pract. Periodontics Aesthet. Dent. 2000;12:467–474.
    1. Kan JY, Rungcharassaeng K. Immediate placement and provisionalization of maxillary anterior single implants: A surgical and prosthodontic rationale. Pract. Periodontics Aesthet. Dent. 2000;12:817–824.
    1. Weigl P, Strangio A. The impact of immediately placed and restored single-tooth implants on hard and soft tissues in the anterior maxilla. Eur. J. Oral Implantol. 2016;9:S89–106.
    1. Al Kudmani H, Jasser R, Andreana S. Is bone graft or guided bone regeneration needed when placing immediate dental implants? A systematic review. Implant Dent. 2017;26:936–944. doi: 10.1097/ID.0000000000000689.
    1. Clementini M, et al. Dimensional changes after immediate implant placement with or without simultaneous regenerative procedures: A systematic review and meta-analysis. J. Clin. Periodontol. 2015;42:666–677. doi: 10.1111/jcpe.12423.
    1. Javed F, Romanos GE. The role of primary stability for successful immediate loading of dental implants A Literature Review. J. Dent. 2010;38:612–620. doi: 10.1016/j.jdent.2010.05.013.
    1. General Assembly of the World Medical Association World medical association declaration of Helsinki: Ethical principles for medical research involving human subjects. J. Am. Coll. Dent. 2014;81:14–18.
    1. Meredith N, Alleyne D, Cawley P. Quantitative determination of the stability of the implant-tissue interface using resonance frequency analysis. Clin. Oral Implants Res. 1996;7:261–267. doi: 10.1034/j.1600-0501.1996.070308.x.
    1. Belser UC, et al. Outcome evaluation of early placed maxillary anterior single-tooth implants using objective Esthetic criteria: A cross-sectional, retrospective study in 45 patients with a 2- to 4-year follow-up using pink and white esthetic scores. J. Periodontol. 2009;80:140–151. doi: 10.1902/jop.2009.080435.
    1. Quirynen M, Van Assche N, Botticelli D, Berglundh T. How does the timing of implant placement to extraction affect outcome? Int. J. Oral Maxillofac. Implants. 2007;22:203–223.
    1. Buser D, Chen ST, Weber HP, Belser UC. Early implant placement following single-tooth extraction in the esthetic zone: Biologic rationale and surgical procedures. Int. J. Periodontics Restorative Dent. 2008;28:441–451.
    1. Esposito M, Grusovin MG, Polyzos IP, Felice P, Worthington HV. Timing of implant placement after tooth extraction: Immediate, immediate-delayed or delayed implants? A cochrane systematic review. Eur. J. Oral Implantol. 2010;3:189–205.
    1. Del Fabbro M, Ceresoli V, Taschieri S, Ceci C, Testori T. Immediate loading of postextraction implants in the esthetic area: Systematic review of the literature. Clin. Implant Dent. Relat. Res. 2015;17:52–70. doi: 10.1111/cid.12074.
    1. Elian N, Cho SC, Froum S, Smith RB, Tarnow DP. A simplified socket classification and repair technique. Pract. Proced. aesthetic Dent. 2007;19:99–104.
    1. Kan JYK, et al. Classification of sagittal root position in relation to the anterior maxillary osseous housing for immediate implant placement: A cone beam computed tomography study. Int. J. Oral Maxillofac. Implants. 2011;26:873–876.
    1. Spielman HP. Influence of the implant position on the aesthetics of the restoration. Pract. Periodontics Aesthet. Dent. 1996;8:897–904.
    1. De Rouck T, Eghbali R, Collys K, De Bruyn H, Cosyn J. The gingival biotype revisited: Transparency of the periodontal probe through the gingival margin as a method to discriminate thin from thick gingiva. J. Clin. Periodontol. 2009;36:428–433. doi: 10.1111/j.1600-051X.2009.01398.x.
    1. Araújo MG, Linder E, Lindhe J. Bio-oss collagen in the buccal gap at immediate implants: A 6-month study in the dog. Clin. Oral Implants Res. 2011;22:1–8. doi: 10.1111/j.1600-0501.2010.01920.x.
    1. Caneva M, et al. Deproteinized bovine bone mineral in marginal defects at implants installed immediately into extraction sockets: An experimental study in dogs. Clin. Oral Implants Res. 2012;23:106–112. doi: 10.1111/j.1600-0501.2011.02202.x.
    1. Canullo L, Iurlaro G, Iannello G. Double-blind randomized controlled trial study on post-extraction immediately restored implants using the switching platform concept: Soft tissue response Preliminary Report. Clin. Oral Implants Res. 2009;20:414–420. doi: 10.1111/j.1600-0501.2008.01660.x.
    1. Zanetti EM, et al. Modal analysis for implant stability assessment: Sensitivity of this methodology for different implant designs. Dent. Mater. 2018;34:1235–1245. doi: 10.1016/j.dental.2018.05.016.
    1. Zanetti EM, Pascoletti G, Cali M, Bignardi C, Franceschini G. Clinical assessment of dental implant stability during follow-up: What is actually measured, and perspectives. Biosensors. 2018;8:68. doi: 10.3390/bios8030068.
    1. Soto-Peñaloza D, et al. Effect on osseointegration of two implant macro-designs: A histomorphometric analysis of bicortically installed implants in different topographic sites of rabbit’s tibiae. Med. Oral Patol. Oral Cir. Bucal. 2019;24:e502–e510.

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