Facial Gingival Changes With and Without Socket Gap Grafting Following Single Maxillary Anterior Immediate Tooth Replacement: One-Year Results
This 1-year prospective study evaluated horizontal and vertical facial gingival tissue changes after immediate implant placement and provisionalization (IIPP) with and without bone graft in the implant-socket gap (ISG). During IIPP, 10 patients received bone graft material in the ISG (G group), while the other 10 patients did not (NG group). The implants were evaluated for implant stability quotient (ISQ), modified plaque index (mPI), modified bleeding index (mBI), marginal bone level (MBL), facial gingival level (FGL), and facial gingival profile (FGP) changes. The mean ISQ value at 9-month follow-up was statistically significantly greater than on the day of implant surgery (P < .05). The mPI and mBI scores demonstrated that patients were able to maintain a good level of hygiene. There were no statistically significant differences in the mean MBL changes between the G and NG groups (P > .05). There were statistically significant differences in FGL changes between the G (-0.77 mm) and NG (-1.35 mm) groups (P = .035). There were no statistically significant differences in FGP changes between the G and NG groups (P > .05). However, statistically significant differences were noted in FGP change between the 3–12 and 0–12 month intervals in both groups (P < .05). Within the limitations of this study, although no significant differences were noted in FGP changes between groups, G group experienced significantly less FGL changes than NG group. Bone graft material placement into ISG seems to be advantageous for tissue preservation during IIPP. However, future long-term studies, with larger sample size, are needed to validate the efficacy of such procedure

Figure 1. Preoperative labial view of the failing maxillary right lateral incisor. Figure 2. Preoperative occlusal view of the failing maxillary right lateral incisor. Figure 3. Labial view of implant placed immediately after tooth extraction. Figure 4. Occlusal view immediately after implant placement. Figure 5. Labial view immediately after provisional delivery. Figure 6. Labial view 9 months after the implant surgery; provisional was removed prior to final impression.

Figure 7. Labial view 9 months after the implant surgery; customized abutment was torqued to 25 Ncm. Figure 8. Labial view 9 months after the definitive restoration delivery. Figure 9. Labial view of the definitive restoration after 1 year of implant surgery. Figure 10. Occlusal view of the definitive restoration after 1 year of implant surgery.

Workflow of surface scan measurement. (a) Master cast was scanned. (b) Surface scan on the day of surgery, at 3 months, and at 12 months follow-up. (c) Surface scans were superimposed. The crown long axis (XY), bisecting the crown, was used as reference line for facial gingival level and profile change measurement.

and 13. Figure 12. Facial gingival level change measurement. Figure 13. Facial gingival profile change measurement.
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