title: 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.
abstract: 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 crown were prospectively followed for 12 months. Clinical, radiologic, and esthetic parameters were recorded to assess treatment outcomes.
  
  
  RESULTS
  At the 12-month examination, all 20 implants were 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 a white 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, with mean bone loss of 0.18 mm at 12 months. 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 demonstrated successful tissue integration for all 20 implants. The short-term follow-up of 12 months revealed pleasing esthetic outcomes overall, as assessed by objective parameters. The risk for mucosal recession was 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.
authors.affiliation: Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Buser
authors.forename: Sandro
authors.initials: S
authors.lastname: Halbritter
authors.forename: Chris
authors.initials: C
authors.lastname: Hart
authors.forename: Michael M
authors.initials: MM
authors.lastname: Bornstein
authors.forename: Linda
authors.initials: L
authors.lastname: Grütter
authors.forename: Vivianne
authors.initials: V
authors.lastname: Chappuis
authors.forename: Urs C
authors.initials: UC
authors.lastname: Belser
mesh_terms: D000328:Adult; D016301:Alveolar Bone Loss / Q000145:classification / Q000000981:diagnostic imaging; D000540:Alveolar Ridge Augmentation / Q000379:methods; D001861:Bone Regeneration / Q000502:physiology*; D003442:Crowns; D003758:Dental Implantation, Endosseous; D019250:Dental Implants, Single-Tooth; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D004955:Esthetics, Dental; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000033:anatomy & histology; D005889:Gingival Recession / Q000145:classification; D048091:Guided Tissue Regeneration / Q000379:methods*; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged; D016348:Osseointegration / Q000502:physiology; D011446:Prospective Studies; D011859:Radiography; D014081:Tooth Extraction; D016896:Treatment Outcome; D055815:Young Adult