Clinical Studies Of Immediate Implant Treatment In The Maxillary Anterior Area Using Two Different Connective Tissue Grafts

Objective The aim of this study was to compare the aesthetics effect of immediate implant placement(immediately with pedicle connective tissue grafts or with free connective tissue grafts) and delayed implant placement by recording and analyzing facial gingival tissue thickness(FGTT), esthetic, clinical, and patient-centered.Methods 52 participants who were from the PLA 105 hospital had needed to extract a single tooth or only lost a tooth in maxillary anterior area. 17 participants who had lost a single tooth more than 3 months, which was defined control group, would receive delayed implant. The other 35 participants who had immediately extracted tooth would receive immediate implant, of which 17 participants who had received pedicle connective tissue grafts was defined pedicle group, the others who had received free connective tissue grafts was defined free group. Each group had used temporary restoration, and used personal cobalt-chromium alloy abutment and pocelain crown to complete the final restoration after about 6 months.The FGTT of each group was measured and recorded preoperation and prior to surgery 6 months. And the esthetic outcomes of each group were taken by assessing PES and VAS immediately, 6 months, and 12 months after surgery. Data were analyzed by SPSS 17.0 with P<0.05 as the threshold for statistical significance.Results The implant success rate was 100% for each group, the clinical survival rate of the grafts is 100%(17/17)for the pedicle group and 94.44%( 17/18) for the free group during the following time. The FGTT was 2.70 ± 0.42 mm for the pedicle group, 2.51 ± 0.39 mm for the free group, and 1.76 ± 0.22 mm for delayed group at 6 month after surgery. The FGTT of the pedicle and free group was higher than that of the control group 6 months after surgery(P<0.05), and the FGTT changes(1.55 ± 0.55 mm for pedicle group and 1.36 ± 0.48 mm for free group) did not differ between groups between baseline and 6 months after surgery(P>0.05). The PES and VAS for the delayed group were lower than that for the pedicle group and the free group at each time(P<0.05), while the outcomes failed to demonstrate any statistical difference between the pedicle group the free group(P>0.05).Conclusion Immediate implant placement in the maxillary anterior area using both connective tissue grafts when compared with delayed implant placement gained higher FGTT, better PES and Patient-centered outcome. Immediate implant placement which used regardless of free or pedicle connective tissue grafts in the maxillary anterior aera both achieved good esthetic and patient-centered outcome in a short time,while a pedicle connective tissue graft was more likely to survive,because of better perfusion and blood supply.