A prospective, controlled clinical trial evaluating the clinical radiological and aesthetic outcome after 5 years of immediately placed implants in sockets exhibiting periapical pathology.
OBJECTIVE
The aim was to compare the clinical, aesthetic and radiological outcome of immediately placed implants in sockets with or without periapical pathology 5 years after placement.


METHODS
Twenty-seven patients were followed 5 years after immediate implant placement (test-group: 12 patients with periapical pathologies; control-group: 15 patients without periapical pathology). Clinical (FMBS, FMPS, CAL, keratinized mucosa), aesthetical (length of clinical crown, Papilla index), and radiological (vertical distance implant shoulder to first bone to implant contact (IS-BIC)) parameters were assessed. Both 95% confidence intervals, as well as results of statistical tests (one-sample, two-sample, paired t-test) were provided.


RESULTS
After 5 years the implant survival rate was 100% for all 27 implants. In the test group the width of the keratinized mucosa increased significantly over the observation period (0.8 ± 1.0 mm). Concerning aesthetic parameters at the 3-month as well as at the 5-year examination no statistically significant difference could be found between the two groups. In the control-group the papilla mesial and distal to the implant increased statistically significant during the observation period by 0.5 ± 0.5 and 0.4 ± 0.6 index score points, respectively. The position of the gingival margin at the implant site and the two neighboring teeth remained stable. At the 5-year visit IS-BIC measured between 1.4 ± 0.5 mm (mesial, control) and 1.7 ± 0.7 mm (distal, test), no significant difference could be found between the two groups. Over the observation period no statistically significant change of IS-BIC could be found in the test- as well as in the control-group. None of the examined radiographs revealed any signs of retrograde peri-implantitis.


CONCLUSIONS
The replacement of teeth exhibiting periapical pathologies by implants placed immediately after tooth extraction can be a successful treatment modality with no disadvantages in clinical, aesthetical and radiological parameters to immediately placed implants into healthy sockets.
Clinic for Fixed & Removable Prosthodontics and Dental Material Science, University of Zürich, Zürich, Switzerland. ronald.jung@zzm.uzh.ch
Ronald E
RE
Jung
Balthasar
B
Zaugg
Alexander O H
AO
Philipp
Thomas C
TC
Truninger
David W
DW
Siegenthaler
Christoph H F
CH
Hämmerle
D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000539:Alveolar Process / Q000000981:diagnostic imaging; D018786:Bone Substitutes / Q000627:therapeutic use; D003094:Collagen; D003442:Crowns; D003758:Dental Implantation, Endosseous / Q000379:methods*; D003774:Dental Plaque Index; D004955:Esthetics, Dental; D005500:Follow-Up Studies; D005881:Gingiva / Q000473:pathology; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods; D006801:Humans; D008567:Membranes, Artificial; D008875:Middle Aged; D008903:Minerals / Q000627:therapeutic use; D016348:Osseointegration / Q000502:physiology; D010483:Periapical Diseases / Q000150:complications*; D017622:Periodontal Attachment Loss / Q000150:complications; D010512:Periodontal Index; D011446:Prospective Studies; D011859:Radiography; D014081:Tooth Extraction; D020390:Tooth Socket / Q000601:surgery*; D016896:Treatment Outcome
C106416:Bio-Gide; C077540:Bio-Oss; D018786:Bone Substitutes; D008567:Membranes, Artificial; D008903:Minerals; D003094:Collagen