Immediately restored, single-tapered implants in the anterior maxilla: prosthodontic and aesthetic outcomes after 1 year.
BACKGROUND
Conventional implant protocols advocate a two-stage technique with a load-free, submerged healing period. Recent studies suggest that immediate restoration of single implants may be a viable treatment option.


OBJECTIVE
The purpose of this study was to evaluate prosthodontic and aesthetic peri-implant mucosal outcomes of immediately restored, Southern single-tapered implants in the anterior maxilla after 1 year.


METHODS
Participants (mean age: 43.25 years; range: 23-71 years) satisfying specified inclusion criteria were randomly allocated to conventional two-stage restoration (control group; n=14) and immediate restoration groups (test group; n =14) in a randomized controlled clinical trial. Tapered, roughened-surface Southern implants were placed using a standardized technique, and implant level bone impressions were made. Provisional screw-retained crowns, out of occlusion, were placed at second-stage surgery after 26 weeks for the conventional restoration group, and within 4 hours of implant placement for the immediate restoration group. Both groups had definitive screw-retained metal-ceramic crowns placed in occlusion 8 weeks later. Peri-implant mucosal response and papilla index were recorded 4 weeks after definitive crown placement to allow for mucosal maturation and at 1 year. Prosthodontic and aesthetic outcomes were assessed using established criteria.


RESULTS
There were no significant differences within, or between, the control and test groups for age, gender, bone quality or quantity, implant stability measurements at surgery, or implant length. There were no significant differences in the implant success rate as determined by radiographic bone loss and stability tests after 1 year. There were no significant differences in prosthodontic maintenance, peri-implant mucosal response, and papilla index between the two groups over 1 year.


CONCLUSIONS
Tapered, roughened-surface implants immediately restored with single provisional crowns at surgery and definitive crowns 8 weeks later were as prosthodontically and aesthetically successful as conventionally restored two-stage implants during the first year of service. Restoring single implants immediately with screw-retained crowns is an efficient procedure, but the short-term outcome is by no means superior to a conventional two-stage approach.
Hall
James A G
JA
Oral Implantology Area of Research Strength, Department of Oral Rehabilitation, School of Dentistry, University of Otago, Dunedin, New Zealand.
Payne
Alan G T
AG
Purton
David G
DG
Torr
Brendan
B
Duncan
Warwick J
WJ
De Silva
Rohana Kumara
RK
D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000145:classification; D015519:Bone Density / Q000502:physiology; D003442:Crowns; D000044:Dental Abutments; D003758:Dental Implantation, Endosseous / Q000379:methods; D019250:Dental Implants, Single-Tooth; D017267:Dental Prosthesis Design; D019232:Dental Restoration Failure; D004955:Esthetics, Dental; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000473:pathology; D006801:Humans; D007180:Incisor; D008297:Male; D008437:Maxilla; D008875:Middle Aged; D016348:Osseointegration / Q000502:physiology; D011446:Prospective Studies; D016896:Treatment Outcome