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Immediate and flapless implant insertion and provisionalization using autogenous bone grafts in the esthetic zone: 10‐year results

2020; Wiley; Volume: 31; Issue: S20 Linguagem: Inglês

10.1111/clr.197_13644

1600-0501

Robert Noelken, Wilfried Wagner, Bilal Al‐Nawas,

Reconstructive Facial Surgery Techniques

Background: Since long-term results for immediate implant insertion and provisionalization are rarely reported, it remained an open issue, whether high success rates, marginal bone preservation and esthetic results remain stable for long-term observation periods. Aim/Hypothesis: Therefore, this prospective study examines the 10-year hard and soft tissue changes at immediate inserted and provisionalized implants in the anterior maxilla. Materials and Methods: Meanwhile 37 microthreaded implants were placed in 21 patients into extraction sockets with and without facial bone deficiencies by a flapless approach. Facial gaps and bony defects were grafted with autogenous bone chips. The implants were immediately provisionalized. The primary outcome parameters were the interproximal marginal bone level and the dimension of the facial bony wall. Implant success and Pink Esthetic Score (PES) were considered as secondary outcome parameters. Results: One patient with one implant passed away following 5-year follow-up examination. The remaining 36 implants were still in function at 10-year follow-up. Marginal bone height averaged -0.15 mm apical to implant shoulder. The thickness of the facial bony lamellae increased significantly between pre-op examination and 1-year follow-up (P = 0.002) and thereafter remained stable. The mean PES ratings changed from 10.7 pre-operatively to 11.5 at the 10-year follow-up. Within 10 years of follow-up, 70% of the implants were clinically stable, free of signs of infection and showed bone loss less than 1 mm. Conclusions and Clinical Implications: Interproximal marginal bone levels, survival rates, and esthetic results remain stable at the 10–year follow-up in implants used in an immediate insertion, reconstruction and provisionalization concept. Facial marginal bone resorption is present in single cases, however, this reduction did not affect the clinical stability or PES so far. Keywords: immediate implant placement, immediate provisionalization,facial bony defect, flapless, autogenous bone graft