title: Systematic Review of Soft Tissue Alterations and Esthetic Outcomes Following Immediate Implant Placement and Restoration of Single Implants in the Anterior Maxilla.
abstract: BACKGROUND
  The aim of this review is to assess the outcome of single-tooth immediate implant placement and restoration (IPR) in the maxillary anterior region, with a particular emphasis on soft tissue and esthetic outcomes.
  
  
  METHODS
  An electronic search in Medline, EBSCOhost, and Ovid (PubMed) was performed to identify studies that reported on soft tissue outcomes following immediate placement and restoration of implants in the maxillary esthetic region with a mean follow-up of ≥1 year.
  
  
  RESULTS
  Nineteen studies on single implants inserted immediately into fresh extraction sockets and provisionally restored in the maxillary esthetic region were included. Soft tissue changes were found to be acceptable, with most studies reporting mean gingival recession of 0.27 ± 0.38 mm and mean papillary height loss of 0.23 ± 0.27 mm after follow-up of ≥1 year. Advanced buccal recession (>1 mm) occurred in 11% of cases. Long-term follow-up studies (>2 years) reported that the interdental papillae, in particular, showed a tendency to rebound over time. The few studies that reported on patient-centered outcomes showed a high level of patient satisfaction with the outcomes of IPR treatment.
  
  
  CONCLUSIONS
  The IPR protocol resulted in generally acceptable soft tissue and esthetic outcomes, with suboptimal results reported in ≈11% of low-risk cases. Factors such as preoperative tissue biotype or use of a flap or connective tissue graft did not significantly influence soft tissue and esthetic outcomes. Long-term prospective controlled clinical trials are necessary to identify factors that may influence the esthetic outcomes associated with IPR.
authors: School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia.|University of Tripoli, Tripoli, Libya.
authors: Nabil
authors: N
authors: Khzam
authors: School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia.
authors: Himanshu
authors: H
authors: Arora
authors: School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia.
authors: Paul
authors: P
authors: Kim
authors: School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia.
authors: Anthony
authors: A
authors: Fisher
authors: Faculty of Dentistry, University of Hong Kong, Prince Philip Dental Hospital, Hong Kong SAR, China.
authors: Nikos
authors: N
authors: Mattheos
authors: School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia.
authors: Saso
authors: S
authors: Ivanovski
mesh_terms: D003758:Dental Implantation, Endosseous; D019250:Dental Implants, Single-Tooth; D004954:Esthetics; D004955:Esthetics, Dental; D005889:Gingival Recession / Q000601:surgery; D006801:Humans; D008437:Maxilla / Q000601:surgery; D011446:Prospective Studies
keywords: Dental implants; esthetics; gingival recession; maxilla; patient satisfaction; prospective studies; single-tooth