| Background: At present,more and more patients concern about the length of the implanttreatment cycle,the size of the trauma and the aesthetic effect．Modern implant restorationphilosophy is simply,immediately,aesthetically,oriented with the Prosthesis restoration,whichput forward to the higher demands and challenges of the Oral Implantology technology,theimplant treatment cycle of Classic delayed implant is long,the physiological absorption ofbone tissue and the graft bring higher difficulty and soft tissue aesthetics risk．Immediateflapless implant replacement is a technology that setting out a temporary crown onimplant-supported prosthesis immediately after tooth extraction．It does not damage thegingival tissue,preserve the blood supply of the alveolar ridge,maintain the original gingivalcontour and shape．Patients are willing to accept this repair of minimally invasive whichreduce patients’ injury and pain, instantly restore the patients’ appearance and pronunciation,avoid psychological and social impact of the toothless period．However,the stability among peri-implant bone and soft tissue of immediate flaplessimplant replacement of single tooth in the esthetic zone has no unified cognition．Thereforethis research could provide theoretical basis for the selection and design of implants,so as toimprove clinical aesthetic effects of dental implants．Objective: Through the clinical research of the stability among peri-implant bone andsoft tissue of immediate flapless implant replacement of single tooth in the esthetic zone,so asto provide objective basis for the selection and design of implants．Methods:16patients are randomly selected from the outpatient who accepted dentalimplantation while the single tooth in the esthetic zone cannot be reserved．Inclusion criteria:ideal soft tissue contour at the facial aspect of the hopeless tooth in perfect harmony with thesurrounding teeth； has a normal gingival biotype; no smoking history； no implantcontraindications.16Replace/3I implants were inserted immediately after minimally invasiveextraction in esthetic zone．If the bone gap between implant and the facial wall is more than2mm, we impacted with bone graft material and PRF,if the bone gap is less than2mm,we impacted with PRF. Plastic crown and acrylic fixed prostheses were finished immediatelyleaving0.5-1mm occlusal space made sure that the provisional restoration was cleared of allcontact in centric occlusion in order to avoid full functional loading of the implant duringhealing. Select healthy teeth of the same name as that of the control group．We observed themodified plaque the index (mPLI), modified sulcus bleeding index (MBI), probing depth (PD),bone loss, gingival recession,aspartate aminotransferase (AST), alkaline phosphatase (ALP)and patient satisfaction (VAS) at the time of1,3,6,12,18,24,30,36months after implantation．Results: One patient quitted follow-up at the observation period,and the remaining15implants got a good bone and soft tissue stability and aesthetic effect．The PD of1,3,6,12months was significantly higher than the natural teeth,there has a significant difference (P<0.05), after12months there has no significant difference (P>0.05)；The recession of softtissue height is0.37mm in the first three months, the increase of soft tissue height is0.13mmbetween3to6months,and the recession of soft tissue height is0.39mm within three years；the peri-implant bone mass increased most notable within3months after implantation,at anincrease height of approximately2.02mm,6months peaked2.13mm．After6months,the bonetissue showed an overall trend of slow absorption,the bone loss at the3years is0.58mm whencompared to the6months; The AST, ALP level of implants is higher than that of natural teethat1,3,and6months after implantation,there has a significant difference (P <0.05)；Patients’aesthetic satisfaction was98%．Conclusion: Based On the strict control of indication,the ideal clinical aestheticeffect,the stability among peri-implant bone and soft tissue and the original gingival contourand shape could be achieved using immediate flapless implant replacement of single tooth．... |
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