Long-term stability of contour augmentation with early implant placement following single tooth extraction in the esthetic zone: a prospective, cross-sectional study in 41 patients with a 5- to 9-year follow-up.
BACKGROUND
Early implant placement with simultaneous contour augmentation is documented with short- and medium-term studies. The long-term stability of contour augmentation is uncertain.


METHODS
In this prospective, cross-sectional study, 41 patients with an implant-borne single crown were examined twice, in 2006 and 2010. Clinical, radiologic, and esthetic parameters were assessed at both examinations. In addition, a cone beam computed tomographic (CBCT) image was obtained during the second examination to assess the dimensions of the facial bone wall.


RESULTS
All 41 implants demonstrated ankylotic stability without signs of peri-implant infection at both examinations. The clinical parameters remained stable over time. Satisfactory esthetic outcomes were noted, as assessed by the pink and white esthetic score (PES/WES) indices. Overall, the PES scores were slightly higher than the WES scores. None of the implants developed mucosal recession over time, as confirmed by values of the distance between implant shoulder and mucosal margin and cast measurements. The periapical radiographs yielded stable peri-implant bone levels, with a mean distance between implant shoulder and first visible bone-implant contact value of 2.18 mm. The CBCT analysis demonstrated a mean thickness of the facial bone wall ≈2.2 mm. In two implants (4.9%) no facial bone wall was detectable radiographically.


CONCLUSIONS
This prospective cross-sectional study demonstrates stable peri-implant hard and soft tissues for all 41 implants examined and satisfactory esthetic outcomes overall. The follow-up of 5 to 9 years confirmed again that the risk for mucosal recession is low with early implant placement. In addition, contour augmentation with guided bone regeneration was able to establish and maintain a facial bone wall in 95% of patients.
Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
Daniel
D
Buser
Vivianne
V
Chappuis
Michael M
MM
Bornstein
Julia-Gabriela
JG
Wittneben
Marc
M
Frei
Urs C
UC
Belser
D000293:Adolescent; D000328:Adult; D000368:Aged; D000539:Alveolar Process / Q000000981:diagnostic imaging; D015331:Cohort Studies; D054893:Cone-Beam Computed Tomography / Q000379:methods; D003430:Cross-Sectional Studies; D003442:Crowns; D003758:Dental Implantation, Endosseous / Q000379:methods; D019250:Dental Implants, Single-Tooth; D019094:Dental Prosthesis, Implant-Supported; D004955:Esthetics, Dental; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000473:pathology; D005889:Gingival Recession / Q000145:classification; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D016348:Osseointegration / Q000502:physiology; D011446:Prospective Studies; D016300:Radiography, Bitewing; D012189:Retrospective Studies; D020390:Tooth Socket / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult