title: Peri-implant tissue response following connective tissue and bone grafting in conjunction with immediate single-tooth replacement in the esthetic zone: a case series.
abstract: OBJECTIVE
  This case series evaluated the peri-implant tissue response following extraction and immediate placement and restoration of an implant in conjunction with subepithelial connective tissue grafting (SCTG) and bone grafting in the esthetic zone. Implant success rates and the peri-implant tissue response were also reported.
  
  
  METHODS
  Ten patients (four men, six women) with a mean age of 48 years (range, 35 to 70) underwent extraction and immediate tooth replacement with SCTG and were evaluated clinically and radiographically presurgically (T0), immediately after immediate tooth replacement and SCTG (T1), and at 3 months (T2), 6 months (T3), and 12 months (T4) after surgery. Data was analyzed using Friedman and Wilcoxon signed-ranks tests at the significance level of a = .05.
  
  
  RESULTS
  At 1 year, all implants remained osseointegrated, with an overall mean marginal bone change of +0.10 mm and a mean facial gingival level change of -0.05 mm. Modified Plaque Index scores showed that patients were able to maintain a good level of hygiene throughout the study. Papilla Index scores indicated that at T4, more than 50% papilla fill was observed in 80% of all sites.
  
  
  CONCLUSIONS
  The results of this case series suggest that, in addition to a favorable implant success rate and peri-implant tissue response, the facial gingival level around single immediately placed implants can also be maintained following connective tissue grafting when proper three-dimensional implant positioning is achieved and bone is grafted into the implant-socket gap.
authors.affiliation: Department of Restorative Dentistry, Loma Linda University School of Dentistry, California 92350, USA. tsudadosue@hotmail.co.jp
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Tsuda
authors.forename: Kitichai
authors.initials: K
authors.lastname: Rungcharassaeng
authors.forename: Joseph Y K
authors.initials: JY
authors.lastname: Kan
authors.forename: Phillip
authors.initials: P
authors.lastname: Roe
authors.forename: Jaime L
authors.initials: JL
authors.lastname: Lozada
authors.forename: Grenith
authors.initials: G
authors.lastname: Zimmerman
mesh_terms: D000328:Adult; D000368:Aged; D000539:Alveolar Process / Q000473:pathology; D001857:Bone Matrix / Q000637:transplantation; D018786:Bone Substitutes / Q000627:therapeutic use*; D003238:Connective Tissue / Q000637:transplantation; D000044:Dental Abutments; D019250:Dental Implants, Single-Tooth; D003774:Dental Plaque Index; D003776:Dental Porcelain / Q000737:chemistry; D017267:Dental Prosthesis Design; D019232:Dental Restoration Failure; D004955:Esthetics, Dental; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000473:pathology / Q000637:transplantation*; D005889:Gingival Recession / Q000209:etiology; D006801:Humans; D057893:Immediate Dental Implant Loading; D008297:Male; D008875:Middle Aged; D008903:Minerals / Q000627:therapeutic use; D009910:Oral Hygiene; D016348:Osseointegration / Q000502:physiology; D014081:Tooth Extraction; D020390:Tooth Socket / Q000601:surgery; D016896:Treatment Outcome; D015040:Zirconium / Q000737:chemistry
chemical_list: C077540:Bio-Oss; D018786:Bone Substitutes; D008903:Minerals; D003776:Dental Porcelain; D015040:Zirconium; C028541:zirconium oxide