title: Immediate implant placement and provisionalization in the aesthetic zone using a flapless or a flap-involving approach: a randomized controlled trial.
abstract: We conducted a randomized controlled trial to compare the effect of flapless (FLS) or flap-involving (F) immediate placement and provisionalization of single-tooth implants in the aesthetic zone.
  
  
  
  Thirty-nine patients were randomized following extraction of a non-restorable tooth to a FLS or F group. All implants were immediately placed and provisionalized. We monitored prospectively changes in the peri-implant mucosal margin, the interproximal bone and buccal horizontal ridge at 3, 6 and 12 months.
  
  
  
  At 3 months post-surgery, the mean ± SD [median (interquartile range)] mesiobuccal peri-implant gingival margin recession from the pre-surgical soft tissue position amounted to 0.11 ± 0.32 mm [0 (0, 0.5)] in the FLS treatment arm versus 0.43 ± 37 mm [0.5 (0, 0.5)] in the F treatment arm (p = 0.02); corresponding values at the distobuccal surface were 0.11 ± 32 mm [0 (0, 0)] in the FLS arm versus 0.48 ± 0.44 mm [0.5 (0, 1)] in the F arm (p = 0.01). No other significant differences in soft or hard tissue remodelling between the treatment arms were observed at 3, 6 or 12 months.
  
  
  
  Flapless and a flap-involving immediate implant placement and provisionalization in the aesthetic zone resulted in comparable remodelling of the peri-implant mucosa, interproximal bone and buccal ridge at 6 and 12 months.
authors: Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, USA.
authors: Janet
authors: J
authors: Stoupel
authors: Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, USA.
authors: Chun-Teh
authors: CT
authors: Lee
authors: Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, USA.
authors: Jaclyn
authors: J
authors: Glick
authors: Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, USA.
authors: Elena
authors: E
authors: Sanz-Miralles
authors: Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors: Cody
authors: C
authors: Chiuzan
authors: Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, USA.
authors: Panos N
authors: PN
authors: Papapanou
mesh_terms: D019250:Dental Implants, Single-Tooth; D004955:Esthetics, Dental; D005889:Gingival Recession; D006801:Humans; D013524:Surgical Flaps
keywords: aesthetics; alveolar process; dental implants; gingival recession; surgical flap