Bone And Soft Tissue Dimension Alteration After Immediate Implant Placement And Immediate Provisionalization Of Single-tooth Implant In Posterior—A Case Series

Objective: To evaluate the survival rate of implants and the alteration of dimension of soft/hard tissue subject to immediate implant placement and immediate provisionalization of single tooth in fresh socket in posterior region.Discuss the risk factors related and the cautions in treatment and provide some references for implant treatment in posterior area.Materials and Methods: A total of 18 patients(10 females with 10 implants and 8 males with 10 implants),19 to 57 years old,were enrolled in this study at the Department of Implantology of Affiliated Stomatological Hospital of Nanchang University from June 2016 to June 2017.All the patients with a single(or two located in different quadrant)failing tooth in posterior were followed the same treatment strategy that involved flapless immediate implant placement and immediate screw-retained provisionalization.The final restoration was completed 6 months after placement.The profile of buccal soft tissues and the index of gingival papilla were recorded before extraction and after final restoration,the data were analyzed using a Wilcoxon signed rank test.The width of the med-facial keratinized gingival was recorded before extraction and after final restoration,and a paired sample mean t-test was used.Cone Beam CT was taken immediately after provisionalization and after final restoration to measure the level and thickness of the buccal bone at the implant site,the data were analyze by a paired sample mean t-test.Results: The implant survival rate in this study was 100%.There was no significant difference in gingival papilla index and the contour of buccal soft tissue between extraction and after final restoration(P>0.05).The width of med-facial keratinized gingival suffer an average of 0.15±0.09 mm recession(P<0.01).The CBCT revealed an average lost in buccal bone level of 0.3±0.13mm(P<0.01),and an average lost in buccal bone thickness of 0.9± 0.28mm(P<0.01).Conclusions: Within the limits of the data from this study,it can be suggested that immediate placement and provisionalization of a single-tooth implant can be a valid and successful option of treatment in the case of single compromised tooth in posterior ridge.Moreover,this treatment protocol seems to maintain the preexisting architecture of soft tissues in most cases,but compromised in buccal bone dimension alteration.Nonetheless,studies with longer follow-up time and larger simple size were needed for more convincing conclusions.