title: Influence of immediate implant loading on peri-implant soft tissue morphology in the edentulous maxilla.
abstract: OBJECTIVE
  This study investigates the pre- and posttreatment morphology of the mucosa around immediately loaded implants in the edentulous maxilla.
  
  
  METHODS
  Implants were placed and immediately loaded in edentulous maxillae; pre- and posttreatment impressions were obtained. The resulting casts were digitalized into 3-dimensional images, and the pre- and posttreatment images were superimposed. The width and height of the maxillary alveolar process were measured at central and interproximal implant sites in a vertical section of the superimposed holograms. For statistical analysis, the Delta value (d) was defined as the difference between the pre- and posttreatment images for all measurements.
  
  
  RESULTS
  Sixty-seven Straumann implants placed in 9 patients and immediately restored with provisional fixed restorations were analyzed. An increase in width at all measurement sites was observed after treatment. Width increased for both central implant (1.51 +/- 1.16 mm, P < .001) and interproximal implant sections (1.02 +/- 1.21 mm, P < .001). Mean d for height was found to be decreased at central implant sites (-1.21 +/- 1.67 mm, P = .012) and at interproximal sections (-0.72 +/- 1.68 mm, P = .098).
  
  
  CONCLUSIONS
  Clinically, it has been observed that the placement of an immediate provisional affects the peri-implant tissue morphology according to its emergence profile. The result after treatment was a wider contour of the peri-implant soft tissue, located in a more apical position than the original mucosal level. The most coronal part of the papilla-like mucosa at interproximal sites would be nearest to the original mucosal level before treatment. The scalloped mucosal configuration obtained was consistent along the rehabilitated arch. Statistically significant dimensional changes of the peri-implant mucosa were observed with an immediate loading approach.
authors.affiliation: Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA. german_gallucci@hsdm.harvard.edu
authors.forename: German O
authors.initials: GO
authors.lastname: Gallucci
authors.forename: Anestis
authors.initials: A
authors.lastname: Mavropoulos
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bernard
authors.forename: Urs C
authors.initials: UC
authors.lastname: Belser
mesh_terms: D000539:Alveolar Process / Q000473:pathology; D017076:Computer-Aided Design; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D005881:Gingiva / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007575:Jaw, Edentulous / Q000473:pathology*; D008437:Maxilla / Q000473:pathology*; D009061:Mouth Mucosa / Q000473:pathology*; D010519:Periodontium / Q000473:pathology*
chemical_list: D015921:Dental Implants