The impact of immediate placement on the aesthetic outcome of maxillary anterior single-tooth implants: a retrospective study in 91 patients
Georgios KAMPEROS, Ioanna ZAMBARA, Vassileios PETSINIS, Dimitrios ZAMBARAS
1,3Department of Oral and Maxillofacial Surgery (Head: Prof. I. Iatrou), Dental School, National and Kapodistrian University of Athens, Greece,
2,4Department of Dental Implants & Tissue Regeneration (Head: D. Zambaras), «HYGEIA» Hospital, Athens, Greece
Hellenic Archives of Oral & Maxillofacial Surgery (2016) 1, 5-11
SUMMARY: Dental implant aesthetics of the anterior maxilla is mainly dependent on the architecture of the soft tissues.
Aim: To evaluate the impact of immediate placement on the aesthetic outcome of maxillary anterior single-tooth implants.
Materials and Methods: Data were collected from the archives of the Department of Dental Implants & Tissue Regeneration, at «HYGEIA» Hospital, during a 5 years period (2010-2014). The time of implant placement was recorded. The Pink Esthetic Score (PES) of each case was evaluated, with a maximum score of 14.
Results: 91 patients were included in the study. The mean PES was 10.5. The outcome was considered satisfactory (PES ≥ 8) in 89% and (almost) perfect (PES ≥ 12) in 35% of the cases. Immediate implant placement had no im- pact on PES (p>0.05), even though it demonstrated slightly greater variability.
Conclusions: Immediate implant placement does not affect the aesthetic outcome if performed by skilled clinicians.
KEY WORDS: periimplant soft tissue, pink esthetic score, anterior maxilla, dental implant
REFERENCES
Albrektsson T, Zarb G, Worthington P, Eriksson AR: The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants 1: 11-25, 1986
Belser UC, Grütter L, Vailati F, Bornstein MM, Weber HP, Buser D: Outcome evaluation of early placed maxillary anterior single-tooth implants using objective esthetic criteria: a cross-sectional, retro- spective study in 45 patients with a 2- to 4-year follow-up using pink and white esthetic scores. J Periodontol 80: 140-151, 2009
Boardman N, Darby I, Chen S: A retrospective evaluation of aesthetic outcomes for single-tooth implants in the anterior maxilla. Clin Oral Implants Res 27: 443-451, 2016
Botticelli D, Berglundh T, Lindhe J: Resolution of bone defects of vary- ing dimension and configuration in the marginal portion of the peri-implant bone. An experimental study in the dog. J Clin Peri- odontol 31: 309-317, 2004
Buser D, Martin W, Belser UC: Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical consid- erations. Int J Oral Maxillofac Implants 19: 43-61, 2004
Chen ST, Buser D: Esthetic outcomes following immediate and early implant placement in the anterior maxilla--a systematic review. Int J Oral Maxillofac Implants 29: 186-215, 2014
Cooper LF: Objective criteria: guiding and evaluating dental implant esthetics. J Esthet Restor Dent 20: 195-205, 2008
Cosyn J, Eghbali A, De Bruyn H, Collys K, Cleymaet R, De Rouck T: Immediate single-tooth implants in the anterior maxilla: 3-year re- sults of a case series on hard and soft tissue response and aes- thetics. J Clin Periodontol 38: 746-753, 2011
Cosyn J, Eghbali A, De Bruyn H, Dierens M, De Rouck T: Single implant treatment in healing versus healed sites of the anterior maxilla: an aesthetic evaluation. Clin Implant Dent Relat Res 14: 517-526, 2012
Cosyn J, Eghbali A, Hanselaer L, De Rouck T, Wyn I, Sabzevar MM, Cleymaet R, De Bruyn H: Four modalities of single implant treat- ment in the anterior maxilla: a clinical, radiographic, and aesthetic evaluation. Clin Implant Dent Relat Res 15: 517-530, 2013
Cutrim ES, Peruzzo DC, Benatti B: Evaluation of soft tissues around single tooth implants in the anterior maxilla restored with ce- mented and screw-retained crowns. J Oral Implantol38: 700-705, 2012
De Rouck T, Collys K, Cosyn J: Single-tooth replacement in the anterior maxilla by means of immediate implantation and provisionaliza- tion: a review. Int J Oral Maxillofac Implants 23: 897-904, 2008
den Hartog L, Slater JJ, Vissink A, Meijer HJ, Raghoebar GM: Treatment outcome of immediate, early and conventional single-tooth im- plants in the aesthetic zone: a systematic review to survival, bone level, soft-tissue, aesthetics and patient satisfaction. J Clin Peri- odontol 35: 1073-1086, 2008
Dierens M, de Bruecker E, Vandeweghe S, Kisch J, de Bruyn H, Cosyn J: Alterations in soft tissue levels and aesthetics over a 16-22 year period following single implant treatment in periodontally-healthy patients: a retrospective case series. J Clin Periodontol 40: 311- 318, 2013
Felice P, Soardi E, Piattelli M, Pistilli R, Jacotti M, Esposito M: Immediate non-occlusal loading of immediate post-extractive versus delayed placement of single implants in preserved sockets of the anterior maxilla: 4-month post-loading results from a pragmatic multicentre randomised controlled trial. Eur J Oral Implantol 4: 329-344, 2011 Fürhauser R, Florescu D, Benesch T, Haas R, Mailath G, Watzek G:
Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score. Clin Oral Implants Res 16: 639-644, 2005
Fürhauser R, Mailath-Pokorny G, Haas R, Busenlechner D, Watzek G, Pommer B: Esthetics of Flapless Single-Tooth Implants in the An- terior Maxilla Using Guided Surgery: Association of Three-Dimen- sional Accuracy and Pink Esthetic Score. Clin Implant Dent Relat Res 17: 427-433, 2015
Hof M, Pommer B, Ambros H, Jesch P, Vogl S, Zechner W: Does Timing of Implant Placement Affect Implant Therapy Outcome in the Aes- thetic Zone? A Clinical, Radiological, Aesthetic, and Patient-Based Evaluation. Clin Implant Dent Relat Res 17: 1188-1199, 2015
Hof M, Pommer B, Strbac GD, Sütö D, Watzek G, Zechner W: Es- thetic evaluation of single-tooth implants in the anterior maxilla following autologous bone augmentation. Clin Oral Implants Res 24: 88-93, 2013
Lai HC, Zhang ZY, Wang F, Zhuang LF, Liu X, Pu YP: Evaluation of soft-tissue alteration around implant-supported single-tooth restoration in the anterior maxilla: the pink esthetic score. Clin Oral Implants Res 19: 560-564, 2008
Luo Z, Zeng R, Luo Z, Chen Z: Single implants in the esthetic zone: analysis of recent peri-implant soft tissue alterations and patient satisfaction. A photographic study. Int J Oral Maxillofac Implants 26: 578-586, 2011
Meijer HJ, Stellingsma K, Meijndert L, Raghoebar GM: A new index for rating aesthetics of implant-supported single crowns and adjacent soft tissues--the Implant Crown Aesthetic Index. Clin Oral Im- plants Res 16: 645-649, 2005
Noelken R, Neffe BA, Kunkel M, Wagner W: Maintenance of marginal bone support and soft tissue esthetics at immediately provision- alized OsseoSpeed implants placed into extraction sites: 2-year results. Clin Oral Implants Res 25: 214-220, 2014
Perelli M, Abundo R, Corrente G, Saccone C, Zambelli M: Implant- supported prostheses esthetic outcomes after socket preservation technique. J Craniofac Surg 26: 729-730, 2015
Pieri F, Aldini NN, Marchetti C, Corinaldesi G: Esthetic outcome and tissue stability of maxillary anterior single-tooth implants following reconstruction with mandibular block grafts: a 5-year prospective study. Int J Oral Maxillofac Implants 28: 270-280, 2013
Raes F, Cosyn J, Crommelinck E, Coessens P, De Bruyn H: Immediate and conventional single implant treatment in the anterior maxilla: 1-year results of a case series on hard and soft tissue response and aesthetics. J Clin Periodontol 38: 385-394, 2011
Rieder D, Eggert J, Krafft T, Weber HP, Wichmann MG, Heckmann SM: Impact of placement and restoration timing on single-implant esthetic outcome - a randomized clinical trial. Clin Oral Implants Res 27: 80-86, 2016
Smith DE, Zarb GA: Criteria for success of osseointegrated en- dosseous implants. J Prosthet Dent 62: 567-572, 1989
1,3Department of Oral and Maxillofacial Surgery (Head: Prof. I. Iatrou), Dental School, National and Kapodistrian University of Athens, Greece,
2,4Department of Dental Implants & Tissue Regeneration (Head: D. Zambaras), «HYGEIA» Hospital, Athens, Greece
Hellenic Archives of Oral & Maxillofacial Surgery (2016) 1, 5-11
SUMMARY: Dental implant aesthetics of the anterior maxilla is mainly dependent on the architecture of the soft tissues.
Aim: To evaluate the impact of immediate placement on the aesthetic outcome of maxillary anterior single-tooth implants.
Materials and Methods: Data were collected from the archives of the Department of Dental Implants & Tissue Regeneration, at «HYGEIA» Hospital, during a 5 years period (2010-2014). The time of implant placement was recorded. The Pink Esthetic Score (PES) of each case was evaluated, with a maximum score of 14.
Results: 91 patients were included in the study. The mean PES was 10.5. The outcome was considered satisfactory (PES ≥ 8) in 89% and (almost) perfect (PES ≥ 12) in 35% of the cases. Immediate implant placement had no im- pact on PES (p>0.05), even though it demonstrated slightly greater variability.
Conclusions: Immediate implant placement does not affect the aesthetic outcome if performed by skilled clinicians.
KEY WORDS: periimplant soft tissue, pink esthetic score, anterior maxilla, dental implant
REFERENCES
Albrektsson T, Zarb G, Worthington P, Eriksson AR: The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants 1: 11-25, 1986
Belser UC, Grütter L, Vailati F, Bornstein MM, Weber HP, Buser D: Outcome evaluation of early placed maxillary anterior single-tooth implants using objective esthetic criteria: a cross-sectional, retro- spective study in 45 patients with a 2- to 4-year follow-up using pink and white esthetic scores. J Periodontol 80: 140-151, 2009
Boardman N, Darby I, Chen S: A retrospective evaluation of aesthetic outcomes for single-tooth implants in the anterior maxilla. Clin Oral Implants Res 27: 443-451, 2016
Botticelli D, Berglundh T, Lindhe J: Resolution of bone defects of vary- ing dimension and configuration in the marginal portion of the peri-implant bone. An experimental study in the dog. J Clin Peri- odontol 31: 309-317, 2004
Buser D, Martin W, Belser UC: Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical consid- erations. Int J Oral Maxillofac Implants 19: 43-61, 2004
Chen ST, Buser D: Esthetic outcomes following immediate and early implant placement in the anterior maxilla--a systematic review. Int J Oral Maxillofac Implants 29: 186-215, 2014
Cooper LF: Objective criteria: guiding and evaluating dental implant esthetics. J Esthet Restor Dent 20: 195-205, 2008
Cosyn J, Eghbali A, De Bruyn H, Collys K, Cleymaet R, De Rouck T: Immediate single-tooth implants in the anterior maxilla: 3-year re- sults of a case series on hard and soft tissue response and aes- thetics. J Clin Periodontol 38: 746-753, 2011
Cosyn J, Eghbali A, De Bruyn H, Dierens M, De Rouck T: Single implant treatment in healing versus healed sites of the anterior maxilla: an aesthetic evaluation. Clin Implant Dent Relat Res 14: 517-526, 2012
Cosyn J, Eghbali A, Hanselaer L, De Rouck T, Wyn I, Sabzevar MM, Cleymaet R, De Bruyn H: Four modalities of single implant treat- ment in the anterior maxilla: a clinical, radiographic, and aesthetic evaluation. Clin Implant Dent Relat Res 15: 517-530, 2013
Cutrim ES, Peruzzo DC, Benatti B: Evaluation of soft tissues around single tooth implants in the anterior maxilla restored with ce- mented and screw-retained crowns. J Oral Implantol38: 700-705, 2012
De Rouck T, Collys K, Cosyn J: Single-tooth replacement in the anterior maxilla by means of immediate implantation and provisionaliza- tion: a review. Int J Oral Maxillofac Implants 23: 897-904, 2008
den Hartog L, Slater JJ, Vissink A, Meijer HJ, Raghoebar GM: Treatment outcome of immediate, early and conventional single-tooth im- plants in the aesthetic zone: a systematic review to survival, bone level, soft-tissue, aesthetics and patient satisfaction. J Clin Peri- odontol 35: 1073-1086, 2008
Dierens M, de Bruecker E, Vandeweghe S, Kisch J, de Bruyn H, Cosyn J: Alterations in soft tissue levels and aesthetics over a 16-22 year period following single implant treatment in periodontally-healthy patients: a retrospective case series. J Clin Periodontol 40: 311- 318, 2013
Felice P, Soardi E, Piattelli M, Pistilli R, Jacotti M, Esposito M: Immediate non-occlusal loading of immediate post-extractive versus delayed placement of single implants in preserved sockets of the anterior maxilla: 4-month post-loading results from a pragmatic multicentre randomised controlled trial. Eur J Oral Implantol 4: 329-344, 2011 Fürhauser R, Florescu D, Benesch T, Haas R, Mailath G, Watzek G:
Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score. Clin Oral Implants Res 16: 639-644, 2005
Fürhauser R, Mailath-Pokorny G, Haas R, Busenlechner D, Watzek G, Pommer B: Esthetics of Flapless Single-Tooth Implants in the An- terior Maxilla Using Guided Surgery: Association of Three-Dimen- sional Accuracy and Pink Esthetic Score. Clin Implant Dent Relat Res 17: 427-433, 2015
Hof M, Pommer B, Ambros H, Jesch P, Vogl S, Zechner W: Does Timing of Implant Placement Affect Implant Therapy Outcome in the Aes- thetic Zone? A Clinical, Radiological, Aesthetic, and Patient-Based Evaluation. Clin Implant Dent Relat Res 17: 1188-1199, 2015
Hof M, Pommer B, Strbac GD, Sütö D, Watzek G, Zechner W: Es- thetic evaluation of single-tooth implants in the anterior maxilla following autologous bone augmentation. Clin Oral Implants Res 24: 88-93, 2013
Lai HC, Zhang ZY, Wang F, Zhuang LF, Liu X, Pu YP: Evaluation of soft-tissue alteration around implant-supported single-tooth restoration in the anterior maxilla: the pink esthetic score. Clin Oral Implants Res 19: 560-564, 2008
Luo Z, Zeng R, Luo Z, Chen Z: Single implants in the esthetic zone: analysis of recent peri-implant soft tissue alterations and patient satisfaction. A photographic study. Int J Oral Maxillofac Implants 26: 578-586, 2011
Meijer HJ, Stellingsma K, Meijndert L, Raghoebar GM: A new index for rating aesthetics of implant-supported single crowns and adjacent soft tissues--the Implant Crown Aesthetic Index. Clin Oral Im- plants Res 16: 645-649, 2005
Noelken R, Neffe BA, Kunkel M, Wagner W: Maintenance of marginal bone support and soft tissue esthetics at immediately provision- alized OsseoSpeed implants placed into extraction sites: 2-year results. Clin Oral Implants Res 25: 214-220, 2014
Perelli M, Abundo R, Corrente G, Saccone C, Zambelli M: Implant- supported prostheses esthetic outcomes after socket preservation technique. J Craniofac Surg 26: 729-730, 2015
Pieri F, Aldini NN, Marchetti C, Corinaldesi G: Esthetic outcome and tissue stability of maxillary anterior single-tooth implants following reconstruction with mandibular block grafts: a 5-year prospective study. Int J Oral Maxillofac Implants 28: 270-280, 2013
Raes F, Cosyn J, Crommelinck E, Coessens P, De Bruyn H: Immediate and conventional single implant treatment in the anterior maxilla: 1-year results of a case series on hard and soft tissue response and aesthetics. J Clin Periodontol 38: 385-394, 2011
Rieder D, Eggert J, Krafft T, Weber HP, Wichmann MG, Heckmann SM: Impact of placement and restoration timing on single-implant esthetic outcome - a randomized clinical trial. Clin Oral Implants Res 27: 80-86, 2016
Smith DE, Zarb GA: Criteria for success of osseointegrated en- dosseous implants. J Prosthet Dent 62: 567-572, 1989
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