Immediate Implant Placement And Esthetic Restoration Into Maxillary Anterior Sockets With Labial Plate Defects

PurposeTo purpose a characteristic surgical protocol to reconstruct the facial bone of maxillary anterior socket with labial plate defects in immediate implant placement,and reach a satisfactory esthetic outcome after prosthodontic treatments.Materials and Methods17 patients from Shandong University Stomatological Hospital underwent flap elevation,bone augmentation by guided bone regeneration(GBR),primary suturing assisted by collagen sponge and delayed loading from January 2013 to October 2015 were included.Cone beam computed tomography(CBCT)data was gathered preextraction,immediately after bone grafting and implant placement,and 6 months following implant surgery.Measurements were taken by a customized method at coronal(L1),middle(L2),and apical(L3)level to measure the facial bone reconstruction.And the clinical data was collected to examine success rate of implants,while photographs were taken after prosthodontic treatments to assess pink esthetic score(PES)and white esthetic score(WES)for objective esthetic outcome.At last,the data were analyzed with SPSS software.Results1.The net gain in labial plate:The coronal level(L1)of the labial bone in all sockets pretreatment were,while the middle level(L2)were 0.65 ± 0.65 mm,with the mean of 0,4 mm,and the apical level(L3)were 1.1±1 1.1 mm,with an average of 0.5 mm.These sockets demonstrated radiographic reformation of the buccal alveolar defect at 6 months postsurgery,the coronal net gain in labial bone of the implants were 1.35 ± 0.55mm,the average was 1.3mm,and the middle net gain were 2.6 ± 1.2 mm,the mean value was 2.1 mm,while the apical net gain were 3.45 ± 2.65 mm,with an average of 2:4mm.2.The success rate of implants:The success rate of these socket was 100%,none of these patients occur complications after restoration.3.Esthetic criteria scores:These extraction sockets come out a satisfactory esthetic outcome with pink esthetic score(PES)7.45± 1.85,the average was 7.12,and white esthetic score(WES)was 8.2 ± 1.5 with an average of 8.36.ConclusionFlap evelationn,bone augmentation by guided bone regeneration(GBR),primary suturing assisted by collagen sponge at immediate implant placement into a socket with a labial osseous defect is a viable clinical technique to reconstitute the facial bone coloboma,which lead to satisfactory facial plate thickness,acceptable esthetic outcome and high success rate,and further following is supposed to be continued.