title: Esthetic assessment of immediately restored implants combined with GBR and free connective tissue graft.
abstract: OBJECTIVE
  Esthetic assessment of immediately restored implants combined with GBR and free connective tissue (CT) graft METHODS: A case-control, retrospective study involving 34 patients treated with maxillary anterior single implants, immediately placed and restored. Clinical and esthetic results were analyzed using standard clinical examination and a comprehensive index, comprising pink esthetic and white esthetic scores (PES/WES). The height of the implant crown and the corresponding height of the contralateral tooth crown were measured to identify mucosal recessions. The distance from the mucosal margin to the implant shoulder (DIM) was measured on the master model.
  
  
  RESULTS
  Thirty of 34 implants fulfilled the strict success criteria set for dental implants with regard to osseointegration. Success was defined as implants with bone loss not exceeding 1.5 mm during the first year and loosing not more than 0.2 for each successive year. The other four implants were stable but did not meet the bone loss criteria mentioned above and defined as survived implants. Mean PES/WES was 14.44 ± 2.34 (range: 9-20). Mean PES was 7.12 ± 1.89 (range: 1-10). The highest mean values were achieved for the variable of root convexity/soft tissue color and texture (1.71 ± 0.46) whereas the mesial papilla (1.09 ± 0.62) proved to be the least pleasing. The mean WES was 7.32 ± 1.25 (range: 5-10). The difference between IC and contralateral TC was 0.54 mm. The mean value for the facial DIM was 3.82 ± 0.87 mm.
  
  
  CONCLUSIONS
  An evaluation of soft and hard tissue augmentation in immediately restored immediate implant procedures was employed to obtain stable hard and soft tissues. The combined GBR and CT graft procedure achieved favorable peri-implant soft tissue condition and esthetic results. However, recession and incomplete papillas were frequently observed.
authors.affiliation: Department of Periodontology and Dental Implantology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel. daniaron@netvision.net.il.
authors.forename: Roni
authors.initials: R
authors.lastname: Kolerman
authors.affiliation: Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Joseph
authors.initials: J
authors.lastname: Nissan
authors.affiliation: Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Eitan
authors.initials: E
authors.lastname: Mijiritsky
authors.affiliation: General Practitioner, Private Practice, Calanswa, Israel.
authors.forename: Nasreen
authors.initials: N
authors.lastname: Hamoudi
authors.affiliation: Dental School, University of Varese, Varese, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Mangano
authors.affiliation: Department of Periodontology and Dental Implantology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Haim
authors.initials: H
authors.lastname: Tal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001861:Bone Regeneration; D016022:Case-Control Studies; D003238:Connective Tissue / Q000637:transplantation; D003481:Cuspid; D019250:Dental Implants, Single-Tooth; D003761:Dental Impression Technique; D004955:Esthetics, Dental; D005260:Female; D005889:Gingival Recession / Q000473:pathology; D006801:Humans; D057893:Immediate Dental Implant Loading; D007180:Incisor; D008297:Male; D008437:Maxilla; D008875:Middle Aged; D016348:Osseointegration; D012189:Retrospective Studies; D019228:Tooth Crown / Q000033:anatomy & histology
keywords: connective tissue graft; esthetic assessment; immediate loading; single-tooth implants