Gingival margin changes in maxillary anterior sites after single immediate implant placement and provisionalization: a 5-year retrospective study of 47 patients.
OBJECTIVE
To evaluate gingival margin changes in the esthetic zone after immediate implant placement and provisionalization over 5 years with a custom anatomic provisional abutment.


METHODS
Single maxillary incisor immediate implant placement and provisionalization procedures, completed and followed between February 2006 and August 2006, were analyzed retrospectively. During clinical recalls at 3 months, 1 year, and 5 years, changes in gingival margins were recorded with clinical photographs and recorded in millimeters.


RESULTS
Forty-seven patients each received a single implant (19 central incisors, 28 lateral incisors) and were followed for 5 years. Implants and restorations had a 100% survival rate during the study. The mean gingival margin changes (recession) were 0.17 mm at the time of definitive restoration, 0.27 mm at 3 months, 0.30 mm at 1 year, and 0.30 mm at 5 years. After 5 years, 24 of the 47 implant crowns had no significant gingival recession. All central incisor sites received 4.3-mm-diameter implants and had a mean change in tooth length of 0.03 mm at 5 years. Lateral incisor sites (n=28) received either a 3.5-mm-diameter implant (n=20) or a 4.3-mm-diameter implant (n=8). Lateral sites with the 3.5-mm implant had a mean change in gingival margin height of 0.08 mm of tooth length at 5 years; lateral sites with a 4.3-mm platform displayed a mean change of 0.82 mm of tooth length.


CONCLUSIONS
This study suggests that implant diameter, gingival biotype, surgical technique, and/or the reason for tooth loss can influence the amount of gingival recession occurring over 5 years. Most recession occurred within the first 3 months, between implant placement/provisionalization and definitive restoration. The use of a customized anatomic provisional abutment can reduce the amount and frequency of recession.
Scott B
SB
Ross
Gregory A
GA
Pette
William B
WB
Parker
Patrick
P
Hardigan
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003758:Dental Implantation, Endosseous / Q000009:adverse effects / Q000379:methods*; D019250:Dental Implants, Single-Tooth; D017267:Dental Prosthesis Design; D003794:Dental Restoration, Temporary / Q000379:methods; D005260:Female; D005889:Gingival Recession / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D057893:Immediate Dental Implant Loading / Q000009:adverse effects; D007180:Incisor / Q000601:surgery; D008297:Male; D008437:Maxilla; D008875:Middle Aged; D012189:Retrospective Studies; D016388:Tooth Loss / Q000209:etiology; D055815:Young Adult