Immediate placement and provisionalization of implants in the aesthetic zone with or without a connective tissue graft: A 1-year randomized controlled trial and volumetric study

Wouter G van Nimwegen, Gerry M Raghoebar, Elise G Zuiderveld, Ronald E Jung, Henny J A Meijer, Sven Mühlemann, Wouter G van Nimwegen, Gerry M Raghoebar, Elise G Zuiderveld, Ronald E Jung, Henny J A Meijer, Sven Mühlemann

Abstract

Objective: To volumetrically compare peri-implant mid-facial soft tissue changes in immediately placed and provisionalized implants in the aesthetic zone, with or without a connective tissue graft.

Material and methods: Sixty patients were included. All implants were placed immediately after extraction. After randomization, in one group, a connective tissue graft (test group, n = 30) was inserted at the buccal aspect of the implant. The other group (control group, n = 30) received no connective tissue graft. Clinical parameters, digital photographs and conventional impressions were obtained before extraction (Tpre ) and at 12 months following definitive crown placement (T12 ). The casts were digitized by a laboratory scanner, and a volumetric analysis was performed between Tpre and T12 .

Results: Twenty-five patients in each group were available for analysis at T12 . Volumetric change, transformed to a mean (±SD) change in thickness, was -0.68 ± 0.59 mm (test) and -0.49 ± 0.54 mm (control) with a non-significant difference between groups (p = .189). The mid-facial mucosa level was significantly different between both groups (p = .014), with a mean (±SD) change of +0.20 ± 0.70 mm (test) and -0.48 ± 1.13 mm (control). The Pink Esthetic Score was similar between both groups.

Conclusions: The use of a CTG in immediately placed and provisionalized implants in the aesthetic zone did not result in less mucosal volume loss after 12 months, leading to the assumption that a CTG cannot fully compensate for the underlying facial bone loss, although a significantly more coronally located mid-facial mucosa level was found when a CTG was performed.

Keywords: aesthetic zone; immediate placement; soft tissue graft; volumetric changes.

© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Figures

Figure 1
Figure 1
The stereolithographic files from baseline (yellow) and 1‐year follow‐up (green) were superimposed, and the region of interest was determined (black box)
Figure 2
Figure 2
CONSORT flow diagram

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