title: Aesthetic outcome of immediately restored single implants placed in extraction sockets and healed sites of the anterior maxilla: a retrospective study on 103 patients with 3 years of follow-up.
abstract: OBJECTIVE
  The aim of this study was to compare the aesthetic outcome of single implants in extraction sockets and healed ridges of the anterior maxilla by means of the pink aesthetic score/white aesthetic score (PES/WES) index.
  
  
  METHODS
  This retrospective study was based on data from 103 patients (43 males, 60 females) aged 24-65 years (mean age 41.4 ± 13.8 years) who had been successfully treated with a single implant in the anterior maxilla, in four different clinical centres. Forty-two patients (mean age 46.5 ± 15.1 years) were treated with a single implant in a fresh post-extraction socket (immediate implant treatment, IIT), while 61 patients (mean age 38.0 ± 11.8 years) were treated with a single implant in a healed site (conventional implant treatment, CIT). Two independent calibrated examiners applied the PES/WES index to the 103 single-tooth restorations, respectively 3 months and 3 years after implant placement.
  
  
  RESULTS
  A few biological (4.8%) and prosthetic (8.7%) complications were reported. Both IIT and CIT yielded satisfactory aesthetic outcomes. At the delivery of the final restoration, a PES/WES score of 16.6 ± 2.6 and 15.7 ± 3.0 was reported for IIT and CIT, respectively: this difference was not statistically significant. A higher decrease in the PES/WES score was observed with CIT over time. At 3 years, a PES/WES score of 16.4 ± 2.8 and 15.2 ± 3.3 was reported for IIT and CIT, respectively: this difference was statistically significant. IIT seemed to yield better aesthetic outcomes in young patients (≤30 years), with implants placed in central incisor/cuspid areas, in the presence of bone contouring.
  
  
  CONCLUSIONS
  Both immediate and conventional single-implant treatment in the anterior maxilla can yield satisfactory aesthetic outcomes, when performed by experienced clinicians in well-selected cases. Further studies are needed to confirm these results.
authors.affiliation: Department of Surgical and Morphological Sciences, Dental School, University of Varese, Varese, Italy.
authors.forename: Francesco Guido
authors.initials: FG
authors.lastname: Mangano
authors.affiliation: Private Practice, Bari, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Mastrangelo
authors.affiliation: Private Practice, Rome, Italy.
authors.forename: Fabrizia
authors.initials: F
authors.lastname: Luongo
authors.affiliation: Private Practice, Sao Paulo, Brazil.
authors.forename: Alberto
authors.initials: A
authors.lastname: Blay
authors.affiliation: Private Practice, Sao Paulo, Brazil.
authors.forename: Samy
authors.initials: S
authors.lastname: Tunchel
authors.affiliation: Department of Medical, Oral and Biotechnological Sciences, Dental School, University of Chieti-Pescara, Chieti, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Mangano
mesh_terms: D000328:Adult; D000368:Aged; D003757:Dental Implantation; D019250:Dental Implants, Single-Tooth; D004955:Esthetics, Dental; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D057893:Immediate Dental Implant Loading; D008297:Male; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D013997:Time Factors; D020390:Tooth Socket / Q000601:surgery
keywords: aesthetic outcome; immediate implant treatment; pink aesthetic score/white aesthetic score; single implants