title: Immediate versus Delayed Treatment in the Anterior Maxilla Using Single Implants with a Laser-Microtextured Collar: 3-Year Results of a Case Series on Hard- and Soft-Tissue Response and Esthetics.
abstract: OBJECTIVE
  To compare peri-implant marginal bone loss, soft tissue response, and esthetics following single immediate implant treatment (IIT) and delayed implant treatment (DIT) in the esthetic zone of the maxilla in well-selected patients.
  
  
  METHODS
  Adequate bone volume and ideal soft tissue level/contour were considered requirements for implant therapy, with additional prerequisites for IIT of residual alveolar bone wall integrity and a thick gingival biotype. IIT included immediate placement and provisionalization, while DIT included extraction socket preservation followed by implant placement and provisionalization 4 months later. Cortical bone levels and peri-implant mucosal conditions were evaluated at regular intervals. The esthetic outcome was objectively rated after 3 years using the pink esthetic score (PES) and white esthetic score (WES).
  
  
  RESULTS
  Twelve patients received an immediate Laser-Lok® implant, and 13 patients received a delayed Laser-Lok® implant. No significant differences were found between the study groups regarding survival rate (100%). The mean bone level from the implant/abutment interface was 0.35 ± 0.18 mm for IIT and 0.42 ± 0.21 mm for DIT after 3 years (p > 0.05). Mesial and distal papillae remained stable over time in DIT. A tendency for regrowth of mesial and distal papillae was found following IIT (p < 0.05). Midfacial soft tissues remained stable over time following DIT and IIT.
  
  
  CONCLUSIONS
  Within the limitations of this study (e.g., small sample size, short follow-up duration), the results suggest that regarding success rate, hard/soft tissue responses, and esthetics, DIT and IIT with single Laser-Lok® implants in the anterior maxilla are comparable and predictable options for well-selected patients.
authors.affiliation: Private Implant Periodontal Practice, Rome, Italy.
authors.forename: Renzo
authors.initials: R
authors.lastname: Guarnieri
authors.affiliation: Private Implant Periodontal Practice, Rome, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Belleggia
authors.affiliation: Private Implant Periodontal Practice, Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Grande
mesh_terms: D019250:Dental Implants, Single-Tooth; D004954:Esthetics; D004955:Esthetics, Dental; D006801:Humans; D057893:Immediate Dental Implant Loading; D008437:Maxilla; D020390:Tooth Socket; D016896:Treatment Outcome
keywords: Immediate implant treatment; delayed implant treatment; esthetic zone; laser-microtextured surface