A prospective clinical study of non‐submerged immediate implants: clinical outcomes and esthetic results

Abstract

Objectives: To evaluate healing of marginal defects in immediate transmucosal implants grafted with anorganic bovine bone, and to assess mucosal and radiographic outcomes 3–4 years following restoration. Material and methods: Thirty immediate transmucosal implants in maxillary anterior extraction sites of 30 patients randomly received BioOss™ (N=10; BG), BioOss™ and resorbable collagen membrane (N=10; BG+M) or no graft (N=10; control). Results: Vertical defect height (VDH) reductions of 81.2±5%, 70.5±17.4% and 68.2±16.6%, and horizontal defect depth (HDD) reductions of 71.7±34.3%, 81.7±33.7% and 55±28.4% were observed for BG, BG+M and control groups, respectively, with no significant inter‐group differences. Horizontal resorption was significantly greater in control group (48.3±9.5%) when compared with BG (15.8±16.9%) and BG+M (20±21.9%) groups (P=0.000). Ten sites (33.3%) exhibited recession of the mucosa after 6 months; eight (26.7%) had an unsatisfactory esthetic result post‐restoration due to recession. Mucosal recession was significantly associated (P=0.032) with buccally positioned implants (HDD 1.1±0.3 mm) when compared with lingually positioned implants (HDD 2.3±0.6 mm). In 19 patients followed for a mean of 4.0±0.7 years, marginal mucosa and bone levels remained stable following restoration. Conclusion: BioOss™ significantly reduced horizontal resorption of buccal bone. There is a risk of mucosal recession and adverse soft tissue esthetics with immediate implant placement. However, this risk may be reduced by avoiding a buccal position of the implant in the extraction socket.