Early Implant Placement With Simultaneous Guided Bone Regeneration Following Single-Tooth Extraction in the Esthetic Zone: 12-Month Results of a Prospective Study With 20 Consecutive Patients
Daniel Buser,* Sandro Halbritter,* Chris Hart,* Michael M. Bornstein,* Linda Gru¨tter,†
Vivianne Chappuis,* and Urs C. Belser†
Background: Early implant placement is one of the treatment options in postextraction sites in the anterior maxilla. Implant placement is performed after a soft tissue healing period of 4 to 8 weeks. Implant placement is combined with a simultaneous guided bone regeneration (GBR) procedure to rebuild esthetic facial hard and soft tissue contours.
Methods: In this prospective case-series study, 20 consecutive patients treated with an implant-borne single crownwere prospectively followed for 12months. Clinical, radiologic, and esthetic parameterswere recorded to assess treatment outcomes.
Results:At the 12-month examination, all 20 implantswere successfully integrated, demonstrating ankylotic stability and healthy peri-implant soft tissues as documented by standard parameters. The esthetic outcomes assessed by a pink esthetic score (PES) and awhite esthetic score (WES) demonstrated pleasing results overall. The WES values were slightly superior to the PES values. The periapical radiographs showed minimal crestal bone loss around the used bone level implants, withmean bone loss of 0.18mmat 12months. Only one implant showed >0.5 mm bone loss, combined with minor mucosal recession of 0.5 to 1.0 mm.
Conclusions: This prospective case series study evaluating the concept of early implant placement demon- strated successful tissue integration for all 20 implants. The short-term follow-up of 12months revealed pleasing esthetic outcomes overall, as assessed by objective parameters. The risk formucosal recessionwas low; only one patient showed minor recession of the facial mucosa. These encouraging results need to be confirmed with 3- and 5-year follow-up examinations. J Periodontol 2009;80:152-162.
Bone graft; bone regeneration; case series; clinical trial; gingival recession.
* Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland. † Department of Fixed Prosthodontics and Occlusion, School of Dental Medicine, University of Geneva, Geneva, Switzerland.
Volume 80 • Number 1
I mplant placement following extraction of a single tooth is an often-encountered clinical situation in daily practice. For the clinician(s), this indication
for implant therapy is particularly challenging in the esthetic zone, because patients often have the highest expectations in terms of an esthetic treat- ment outcome. This challenge is based on a variety of local risk factors that are often present in the anterior maxilla.1-4 In addition to immediate and late implant placement, early implant placement is one of the treatment...