title: Immediate loading of implants in the aesthetic zone: comparison between two placement timings.
abstract: OBJECTIVE
  Implant rehabilitation delivered in accordance with the traditional protocol has proven to be highly predictable and acceptable (1). Nevertheless, the application of immediate loading on post-extraction implants, especially for aesthetic zones, has now considerably increased (2). The aim of this work is to illustrate the immediate loading of implants placed in the aesthetic zone through tapered design fixtures with microgeometry of a high degree of porosity inserted at the same time or 4-8 weeks from dental avulsion (TSA® Advance, Phibo®).
  
  
  METHODS
  A total of 15 implant fixtures of which 8 at an interval of 4-8 weeks from extraction (type 2) and the remaining according to the immediate post-extraction technique (type 1) were positioned. All implants were prosthesized within 24 hours from the placement. Definitive crowns replaced provisional restorations after 20-24 weeks. After 4 and 12 months from implant insertion, the following parameters were assessed: X-ray image, pain, mobility or suppuration, soft tissue condition and aesthetic appearance.
  
  
  RESULTS
  Percentage of osseointegration was 93.75%, and 53.5% of the osseointegrated fixtures was type 2. No statistically significant difference between the mean ISQ values for implants of type 1 and 2 both in the post-operative period and after 12 months was evident, indicating that the timing of insertion did not affect the achievement of stability for the implant fixtures tested in our study. Immediate post-extraction implants showed a greater propensity for gingival recession and a peri-implant radiolucency greater than those placed at an interval of 4-8 weeks. The values obtained for the PES/WES and the subjective evaluation of the analyzed sample showed the considerable aesthetic value and the high level of satisfaction guaranteed by the implant technique illustrated.
  
  
  CONCLUSIONS
  Although well-designed, high quality, randomized clinical trials are still needed as well as the requirement to establish a common, complete, and reproducible index for the evaluation of aesthetic outcome, immediate/early placement and loading of a single TSA® Advance, Phibo® may be considered a valuable and predictable option in terms of implant success as well as hard and soft tissue stability.
authors: Department of Surgery and Translational Medicine, University of Milan-Bicocca, Monza, Italy.
authors: Fabrizio
authors: F
authors: Carini
authors: Department of Surgery and Translational Medicine, University of Milan-Bicocca, Monza, Italy.
authors: Salvatore
authors: S
authors: Longoni
authors: Department of Surgery and Translational Medicine, University of Milan-Bicocca, Monza, Italy.
authors: Valeria
authors: V
authors: Pisapia
authors: Department of Surgery and Translational Medicine, University of Milan-Bicocca, Monza, Italy.
authors: Manuel
authors: M
authors: Francesconi
authors: Department of Surgery and Translational Medicine, University of Milan-Bicocca, Monza, Italy.
authors: Vito
authors: V
authors: Saggese
authors: Department of Surgery and Translational Medicine, University of Milan-Bicocca, Monza, Italy.
authors: Gianluca
authors: G
authors: Porcaro
keywords: aesthetic outcome assessment; early post-extraction implant; immediate loading; immediate post-extraction implant; non-functional loading