Esthetic Assessment of Implants Placed into Fresh Extraction Sockets for Single-Tooth Replacements Using a Flapless Approach.
BACKGROUND
To validate the concept of immediate implant placement and nonfunctional loading for use in the esthetically sensitive anterior maxilla, clinical trials should ideally include objective esthetic criteria.


OBJECTIVE
This study analyzed procedural results as graded by the pink esthetic score and white esthetic score (PES/WES).


METHODS
Thirty-nine suitable patients (mean follow-up 44.82 ± 28 months) were evaluated.


RESULTS
Thirty-eight implants fulfilled stringent criteria for successful osseointegration: absence of peri-implant radiolucency, implant mobility, suppuration, and pain. The mean total PES/WES was 15.50 ± 2.67 (range: 10-20). The mean total PES of 7.92 ± 1.60 (range: 5-10) indicated favorable overall peri-implant soft-tissue conditions. Root convexity and texture (1.63 ± 0.54) and curvature of the facial mucosa (1.68 ± 0.47) and distal papilla (1.66 ± 0.48) had the highest mean values, whereas acceptable levels of facial tissue (1.53 ± 0.73) and mesial papilla (1.42 ± 0.64) were the most difficult to fully achieve. The mean mesial and distal bone loss at data collection was, was 1.19 ± 0.54 and 1.15 ± 0.51, respectively. Periodontal disease severity (advanced chronic and aggressive periodontitis) was significantly associated with a low total PES (p = .048).


CONCLUSIONS
Objective PES/WES assessment validated immediate anterior maxillary single-tooth replacement and restoration as being a successful and esthetically predictable treatment modality in sites where the buccal bone had been preserved during the extraction at 1 year of follow-up.
Lecturer, Department of Periodontology, Dental Implantology Tel-Aviv University, Tel-Aviv, Israel.
Roni
R
Kolerman
Senior Lecturer, Department of Oral Rehabilitation Tel-Aviv University, Tel-Aviv, Israel.
Eitan
E
Mijiritsky
Prosthodontist, private clinic, Tel-Aviv, Israel.
Eitan
E
Barnea
Student, DMD Thesis, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Israel.
Areeje
A
Dabaja
Professor, Department of Oral Rehabilitation, Tel-Aviv University, Israel.
Joseph
J
Nissan
Professor, Head of Department of Periodontology, Dental Implantology Tel-Aviv University, Tel-Aviv, Israel.
Haim
H
Tal
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019250:Dental Implants, Single-Tooth; D004955:Esthetics, Dental; D005260:Female; D006801:Humans; D057893:Immediate Dental Implant Loading / Q000379:methods*; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014081:Tooth Extraction; D016896:Treatment Outcome
flapless implant surgery; immediate placement; radiographic data; single-tooth implants