Does the pre-operative buccal soft tissue level at teeth or gingival phenotype dictate the aesthetic outcome after flapless immediate implant placement and provisionalization? Analysis of a prospective clinical case series
Abstract Background Immediate implant placement (IIP) often is related to mid-buccal recession in literature. To draw conclusions about the behavior of the soft tissues following IIP, pre-operative aesthetic measurements have to be taken into account. The aim of analysis of these prospective clinica...
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doaj-82868445b8244969b59bfb0d07443d112021-08-29T11:29:04ZengSpringerOpenInternational Journal of Implant Dentistry2198-40342021-08-01711610.1186/s40729-021-00366-3Does the pre-operative buccal soft tissue level at teeth or gingival phenotype dictate the aesthetic outcome after flapless immediate implant placement and provisionalization? Analysis of a prospective clinical case seriesEdith Groenendijk0Ewald Maria Bronkhorst1Gert Jacobus Meijer2Clinique Implantologie Den HaagDepartment of Preventive and Curative DentistryDepartment of Oral and Maxillofacial SurgeryAbstract Background Immediate implant placement (IIP) often is related to mid-buccal recession in literature. To draw conclusions about the behavior of the soft tissues following IIP, pre-operative aesthetic measurements have to be taken into account. The aim of analysis of these prospective clinical case series data was to elucidate whether the pre-operative buccal soft tissue level (STL) or gingival phenotype influence the 1-year pink aesthetic outcome after performing flapless immediate implant placement and provisionalization (FIIPP) maxillary incisor cases. Materials and methods In 97 patients, a maxillary incisor was replaced performing FIIPP. STL and phenotype were analyzed on light-photographs made pre-operatively (T0), direct post-operatively (T1), after placement of the permanent crown (T2), and 1 year post-operatively (T3). To investigate if a pre-operative buccal soft tissue deficiency or excess influenced the total pink esthetic score (total-PES) per patient at T3, PES-3 was modified by adding a minus (“−”) or plus (“+”) in case of a STL-deficiency or excess, respectively. Results Pre-operatively, 40% of the cases showed a mid-buccal recession (STL-deficiency), 19% STL-excess, while in 41% an equal level in comparison with the contra-lateral tooth was observed (STL-neutral). One year post-operatively, 79% (31/39) of the recession cases showed soft tissue gain, while STL-excess cases showed the highest rate of soft tissue reduction (94%; 17/18). This resulted in a decrease of soft tissue recessions and excesses (to 26% and 4%, respectively), and an increase of ideal STL (PES-3-score 2) to 70%. The 1-year aesthetic outcome was not statistically different (p = 0.577) between patients with a pre-operative soft tissue recession (mean T3 total-PES = 12.18) or STL excess (mean T3 total-PES = 11.94). Of the total population, 71 patients with a thin, and 26 with a thick phenotype were evaluated. No statistical difference (p = 0.08) was present in aesthetic outcome between the two phenotypes (thin mean T3 total-PES = 12.30, thick mean T3 total-PES = 11.65). Conclusion Regardless of phenotype, preoperative soft tissue recession, or excess, comparable high aesthetic outcomes were achieved 1 year post-operatively. Trial registration Ethical approval was obtained and registered on 20 October 2015 ( NTR5583/NL4170 ).https://doi.org/10.1186/s40729-021-00366-3Immediate implant placement and provisionalizationImmediate restorationAesthetic outcomeModified pink esthetic scoreSoft tissue levelMid-buccal recession |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Edith Groenendijk Ewald Maria Bronkhorst Gert Jacobus Meijer |
spellingShingle |
Edith Groenendijk Ewald Maria Bronkhorst Gert Jacobus Meijer Does the pre-operative buccal soft tissue level at teeth or gingival phenotype dictate the aesthetic outcome after flapless immediate implant placement and provisionalization? Analysis of a prospective clinical case series International Journal of Implant Dentistry Immediate implant placement and provisionalization Immediate restoration Aesthetic outcome Modified pink esthetic score Soft tissue level Mid-buccal recession |
author_facet |
Edith Groenendijk Ewald Maria Bronkhorst Gert Jacobus Meijer |
author_sort |
Edith Groenendijk |
title |
Does the pre-operative buccal soft tissue level at teeth or gingival phenotype dictate the aesthetic outcome after flapless immediate implant placement and provisionalization? Analysis of a prospective clinical case series |
title_short |
Does the pre-operative buccal soft tissue level at teeth or gingival phenotype dictate the aesthetic outcome after flapless immediate implant placement and provisionalization? Analysis of a prospective clinical case series |
title_full |
Does the pre-operative buccal soft tissue level at teeth or gingival phenotype dictate the aesthetic outcome after flapless immediate implant placement and provisionalization? Analysis of a prospective clinical case series |
title_fullStr |
Does the pre-operative buccal soft tissue level at teeth or gingival phenotype dictate the aesthetic outcome after flapless immediate implant placement and provisionalization? Analysis of a prospective clinical case series |
title_full_unstemmed |
Does the pre-operative buccal soft tissue level at teeth or gingival phenotype dictate the aesthetic outcome after flapless immediate implant placement and provisionalization? Analysis of a prospective clinical case series |
title_sort |
does the pre-operative buccal soft tissue level at teeth or gingival phenotype dictate the aesthetic outcome after flapless immediate implant placement and provisionalization? analysis of a prospective clinical case series |
publisher |
SpringerOpen |
series |
International Journal of Implant Dentistry |
issn |
2198-4034 |
publishDate |
2021-08-01 |
description |
Abstract Background Immediate implant placement (IIP) often is related to mid-buccal recession in literature. To draw conclusions about the behavior of the soft tissues following IIP, pre-operative aesthetic measurements have to be taken into account. The aim of analysis of these prospective clinical case series data was to elucidate whether the pre-operative buccal soft tissue level (STL) or gingival phenotype influence the 1-year pink aesthetic outcome after performing flapless immediate implant placement and provisionalization (FIIPP) maxillary incisor cases. Materials and methods In 97 patients, a maxillary incisor was replaced performing FIIPP. STL and phenotype were analyzed on light-photographs made pre-operatively (T0), direct post-operatively (T1), after placement of the permanent crown (T2), and 1 year post-operatively (T3). To investigate if a pre-operative buccal soft tissue deficiency or excess influenced the total pink esthetic score (total-PES) per patient at T3, PES-3 was modified by adding a minus (“−”) or plus (“+”) in case of a STL-deficiency or excess, respectively. Results Pre-operatively, 40% of the cases showed a mid-buccal recession (STL-deficiency), 19% STL-excess, while in 41% an equal level in comparison with the contra-lateral tooth was observed (STL-neutral). One year post-operatively, 79% (31/39) of the recession cases showed soft tissue gain, while STL-excess cases showed the highest rate of soft tissue reduction (94%; 17/18). This resulted in a decrease of soft tissue recessions and excesses (to 26% and 4%, respectively), and an increase of ideal STL (PES-3-score 2) to 70%. The 1-year aesthetic outcome was not statistically different (p = 0.577) between patients with a pre-operative soft tissue recession (mean T3 total-PES = 12.18) or STL excess (mean T3 total-PES = 11.94). Of the total population, 71 patients with a thin, and 26 with a thick phenotype were evaluated. No statistical difference (p = 0.08) was present in aesthetic outcome between the two phenotypes (thin mean T3 total-PES = 12.30, thick mean T3 total-PES = 11.65). Conclusion Regardless of phenotype, preoperative soft tissue recession, or excess, comparable high aesthetic outcomes were achieved 1 year post-operatively. Trial registration Ethical approval was obtained and registered on 20 October 2015 ( NTR5583/NL4170 ). |
topic |
Immediate implant placement and provisionalization Immediate restoration Aesthetic outcome Modified pink esthetic score Soft tissue level Mid-buccal recession |
url |
https://doi.org/10.1186/s40729-021-00366-3 |
work_keys_str_mv |
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