title: Immediate implant placement and restoration in the esthetic zone: a prospective study with 18 months of follow-up.
abstract: OBJECTIVE
  This clinical study aimed to assess the dimensional stability of peri-implant soft tissues around immediately placed and restored implants in the maxillary esthetic zone.
  
  
  METHODS
  Twelve systemically healthy patients presenting with a hopeless maxillary central incisor were selected. Provisional restorations were delivered immediately after tooth extraction and implant placement. Periimplant soft tissue dimensions were measured either by direct clinical examination or evaluation of study casts. Measurements were performed before extraction; immediately after implant and restoration placement; and 6 weeks, 3 months, 6 months, 12 months, and 18 months postoperatively. The distances assessed were: tip of the mesial papilla to the mesioincisal edge of the adjacent central incisor, tip of the distal papilla to the mesioincisal edge of the adjacent lateral incisor, and the length of the clinical crown of the definitive restoration.
  
  
  RESULTS
  All patients completed the study, and no implants failed within the 18-month follow-up period (100% survival rate). No statistical differences were observed in the distances between the incisal edge of the adjacent teeth and the mesial and distal papilla tips (P = .303 and .099, respectively) at any follow-up appointment. Likewise, there were no alterations in the definitive clinical crown dimensions during the follow-up period (P = .406).
  
  
  CONCLUSIONS
  The findings of this 18-month prospective study indicate that, within the selection criteria and technique presented in this study, immediate implants with immediate restorations can be a predictable option for the replacement of teeth in the esthetic zone, providing stability to the peri-implant soft tissue.
authors.affiliation: Department of Prosthodontics, School of Dentistry of the University of São Paulo, Brazil. tortamano@usp.br
authors.forename: Pedro
authors.initials: P
authors.lastname: Tortamano
authors.forename: Luiz Otávio Alves
authors.initials: LO
authors.lastname: Camargo
authors.forename: Marina Stella
authors.initials: MS
authors.lastname: Bello-Silva
authors.forename: Lúcio Hirokuni
authors.initials: LH
authors.lastname: Kanashiro
mesh_terms: D000328:Adult; D003442:Crowns; D000044:Dental Abutments; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D003794:Dental Restoration, Temporary; D004955:Esthetics, Dental; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000473:pathology; D006801:Humans; D007180:Incisor; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D016348:Osseointegration / Q000502:physiology; D011446:Prospective Studies; D014081:Tooth Extraction; D020390:Tooth Socket / Q000601:surgery; D055815:Young Adult
chemical_list: D015921:Dental Implants