Introduction: 

The scientific rationale for the study was to investigate the benefits of immediate provisionalization on preserving the soft tissue level around immediately placed implants, as conflicting evidence existed on the topic. This study aimed to investigate whether there is a benefit to the appearance of single dental implants when they are provisionally restored immediately after placement, as previous research on this topic has yielded mixed results. The study compared the facial mucosal level of such implants with and without immediate provisionalization.

Methods: 

This study involved 40 participants who received a single dental implant to replace a lost front or premolar tooth in the upper jaw. The implant was randomly assigned to either receive a temporary crown that did not touch the opposing teeth (non-occluding) or a healing abutment after placement. The implant was restored permanently 4 months later, and the participant was followed for 12 months. The study evaluated clinical and radiographic factors for both groups and compared the results.

Results: 

This study found that the implant survival rate at 12 months in the test group was 90%, and 100% in the control group. The study found little change in mid-facial mucosal level and papilla height within both groups and no significant differences between the two groups. The study also found that the amount of marginal bone remodelling was modest, with no significant difference between the two groups. The study found radiographic bone changes were not statistically different between the groups, except for the vertical crestal bone resorption. Additionally, the study suggests that implant positioning, rather than immediate provisionalization, may be the most important factor for determining the facial mucosal level. The study concluded that when implants are placed in an ideal 3D position, with or without immediate provisionalization during immediate implant placement, it does not make a significant difference in terms of mucosal recession or final aesthetic outcomes.

Conclusion:

The study found that both immediately placing dental implants and immediately placing and provisionally restoring them can achieve stable vertical soft tissue levels for 12 months when compared to the level prior to extraction. However, the study found that immediately provisionally restoring the implant did not improve aesthetic outcome further. The practical implications of the study are that immediate implant placement can maintain a stable vertical soft tissue level compared to pre-extraction level, and that immediate provisionalization may not provide additional aesthetic benefits.

References

1. Araujo, M. G., Linder, E., & Lindhe, J. (2011). Bio‐Oss collagen in the buccal gap at immediate implants: A 6‐month study in the dog. Clin Oral Implants Res, 22(1), 1–8. https://doi. org/10.1111/j.1600-0501.2010.01920.x
2. Block, M. S., Mercante, D. E., Lirette, D., Mohamed, W., Ryser, M., & Castellon, P. (2009). Prospective evaluation of immediate and delayed provisional single tooth restorations. Journal of Oral and Maxillofacial Surgery, 67(11 Suppl), 89–107. https://doi.org/10.1016/ j.joms.2009.07.009
3. Botticelli, D., Berglundh, T., & Lindhe, J. (2004). Hard‐tissue alterations following immediate implant placement in extraction sites. Journal of Clinical Periodontology, 31(10), 820–828. https://doi. org/10.1111/j.1600-051X.2004.00565.x
4. Chen, S. T., Darby, I. B., & Reynolds, E. C. (2007). A prospective clinical study of non‐submerged immediate implants: Clinical outcomes and esthetic results. Clin Oral Implants Res, 18(5), 552–562. https://doi. org/10.1111/j.1600-0501.2007.01388.x