Soft and hard tissue maintenance after the placement of immediate-loaded implants in the anterior maxilla : photographic and radiographic assessment

• Background: The dynamics of soft and hard tissue volume maintenance following the placement of immediate-loaded implants in aesthetic areas remains unclear in literature. Aim/Hypothesis: To present a method to evaluate by clinical (photography) and radiographic bi- and tri-dimensional means the alterations in soft and hard tissues following immediate implant placement and loading in the anterior maxilla. Material and methods: Ten patients, treated with immediateloaded implants in the maxillary central or lateral incisor, were evaluated in this study. Clinical parameters (distance from the tip of the crown to the interdental papilla – P; distance from the top of the crown to the gingiva – C; keratinized mucosa height – K) were evaluated in standardized pictures taken immediately after (baseline), and 1, 3, and 6 months after provisional implant-supported single crown placement. Bi-dimensional radiographic parameters (distance from the top of the implant to the first bone-to-implant contact – IT-FBIC; distance from the bone crest to the first bone-to-implant contact – BC-FBIC; lateral bone lost at the implant neck – LBL) were evaluated from standardized digital periapical radiographies acquired at the same time points, or from CBCT images (buccal bone wall thickness, measured at the top, the midpoint and the apex of the implant – TT, MT, and AT, respectively) acquired at baseline and 6 months after surgery. The volume of the buccal bone wall covering the central millimeter of the implant (BV) was also assessed in the CBCT images. Comparison among multiple periods of observation were performed using repeated-measures ANOVA followed by Tukey post-hoc test, while two-period based comparison were made using paired t-test. Results: The variation for all clinical (photographic), bi- and tri-dimensional parameters assessed was non-statistically significant. Mean P was 5.55 1 mm, considering all time periods, while C and K were 9.2 1.2 and 5.3 1.6 mm, respectively. Mean IT-FBIC was 1.3 0.8 mm, considering all time periods, whilst BC-FBIC and LBL were 3.9 1.1 and 0.3 0.1 mm, respectively. There was a 94% maintenance of BV. Conclusions and clinical implications: Assessed parameters showed good clinical, bi- and tri-dimensional radiographic stability of soft and hard tissues for implants immediately placed and loaded in aesthetic areas.

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MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Odontologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Dentistry (hsv//eng)

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