Comparison Of Clinical Effects Of Immediate And Delayed Implant-supported Restoration Following Immediate Implant Placement Of Single Tooth In The Aesthetic Zone

ObjectiveTo compare the clinical outcomes of immediate and delayed implant-supported restoration following immediate implant placement of single tooth in the aesthetic zone.Methods40 patients with single teeth immediate implant in the aesthetic zone were selected in the Department of Oral Implantology,First Affiliated Hospital of Zhengzhou University from June 2016 to July 2018,they were randomly divided into two groups with 20 cases in each group.Group A took immediate implant-supported temporary crown after immediate implant placement,and received the definitive restoration 3 months later.Group B received implant-supported temporary crown at 3 months after immediate implant placement,and received the definite restoration at 3 months after provisional restoration.The implant success rate,marginal bone loss(MBL),soft tissue index(papilla index,modified plaque index,modified sulcus bleeding index,probing depth),pink esthetic score(PES),white esthetic score(WES)and patients satisfaction were compared between both groups at 1 month and 1 year after definite restoration.Results(1)Success rate.The implant success rate in both groups was 100%.(2)MBL.At 1 year after permanent restoration,the bone loss of 0.76±0.29 mm mesially and 0.71±0.25 mm distally was observed in Group A,which was not statistically significant when compared with the bone loss of 0.71±0.26 mm and 0.69±0.24 mm,respectively,on the mesial and distal sites in Group B(P>0.05).(3)Soft tissue index.At 1 month and 1 year after permanent restoration,the PI,mPLI,mSBI,and PD between the two groups A and B were all no statistical difference(P>0.05).But with the extension of observation time,the PI of both groups A and B increased.(4)PES.At 1 month and 1 year after permanent restoration,the mean value of PES in Group A were(8.01±1.05)and(7.90±1.10),which were higher than those of Group B(7.80±0.96)and(7.76±1.21),but the difference was not statistically significant(P>0.05).(5)WES.At 1 month and 1 year after permanent restoration,there was no statistical difference in the mean value of WES between groups A and B(P>0.05).(6)Patient satisfaction.At 1 month after permanent restoration,the mean value of VAS(8.84±1.12)in Group A was higher than that of Group B(8.08±0.97),and the difference was significant statistically(P=0.03,P<0.05);At 1 year after permanent restoration,the mean value of VAS of the.two groups A and B were not statistically different(P>0.05).In the two time periods from the day after surgery to 1 month after permanent restoration and 1 month to 1 year after permanent restoration,there was no statistical difference in OHIP-14 index of each dimension between the two groups(P>0.05).ConclusionThere is no significant difference in the effect of immediate implant-supported restoration and delayed implant-supported restoration on soft and hard tissue after immediate implant placement of single tooth in the aesthetic zone,but the satisfaction of patients with immediate restoration is higher than that of delayed restoration.For cases that meet the immediate implant placement requirements,when the patient's aesthetic risk is low,and the implant placement torque?35N·cm,it is recommended to choose immediate restoration,which can not only obtain satisfactory aesthetic outcomes but also shorten the treatment cycle.Under the condition of strict control of indications before operation,standard operation procedure during operation and regular maintenance after operation,immediate restoration and delayed restoration after immediate implant placement can achieve satisfactory aesthetic outcomes.