A Randomized Controlled Trial on the Timing of Soft Tissue Augmentation in Immediate Implant Placement: Soft Tissue Changes and Esthetic Outcome

IF 3.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research Pub Date : 2025-02-21 DOI:10.1111/cid.70013

Thibault Struys, Véronique Christiaens, Thomas De Bruyckere, Jeremy Pitman, Pieter-Jan Van Hove, Jan Cosyn

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Abstract

Aim

To assess the impact of the timing of soft tissue augmentation on soft tissue changes and esthetic outcome following single immediate implant placement (IIP) in the anterior maxilla.

Materials and Methods

Patients with a failing tooth and intact buccal bone wall in the anterior maxilla (15–25) were enrolled in this RCT. Following single IIP and socket grafting, they were randomly allocated to the control group (immediate soft tissue augmentation performed in the same surgical procedure—ISTA) or the test group (delayed soft tissue augmentation performed 3 months later—DSTA). Implants were placed with a surgical guide and immediately restored with an implant-supported provisional crown. Changes in soft tissue dimensions were assessed by a blinded clinician using superimposed STL files taken prior to surgery and at 1-year follow-up. The esthetic outcome was rated by a blinded clinician and the patient at 1-year follow-up. The study adhered to the STA-COSM (Soft Tissue Augmentation—Core Outcome Set and Measurements for implant dentistry trials) guidelines.

Results

Twenty patients were randomized to each group (control: 16 females, 4 males, mean age 57.6; test: 9 females, 11 males, mean age 54.2). The mean change in buccal soft tissue profile was −0.251 and 0.083 mm for ISTA and DSTA, respectively. The mean difference of −0.318 mm in favor of DSTA was not significant (95% CI: −0.860 to 0.224, p = 0.241). Median midfacial recession was −0.200 and − 0.350 mm for ISTA and DSTA, respectively. The median difference of 0.200 mm in favor of ISTA was not significant (95% CI: −0.210 to 0.700, p = 0.311). Mesial and distal papillary recession, Pink Esthetic Score and patients' esthetic satisfaction failed to demonstrate a significant difference between the groups.

Conclusion

In patients with an intact buccal bone wall, the timing of soft tissue augmentation following IIP had no significant impact on soft tissue changes and esthetic outcome.

Trial Registration: ClinicalTrials.gov: NCT05537545

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一项随机对照试验：软组织改变和美学结果

目的探讨上颌前牙单次即刻种植（IIP）后软组织隆胸时机对软组织改变及美观效果的影响。材料与方法选择上颌前牙脱落且颊骨壁完整的患者（15 ~ 25例）。在单次IIP和窝骨移植后，他们被随机分配到对照组（在相同的手术过程中立即进行软组织增强术- ista）或试验组（在3个月后进行延迟软组织增强术- dsta）。种植体在手术指导下放置，并立即用种植体支撑的临时冠修复。一名盲法临床医生使用术前和随访1年的叠加STL文件评估软组织尺寸的变化。美学结果由盲法临床医生和患者在1年随访中评估。该研究遵循STA-COSM（软组织增强-核心结果集和种植牙科试验测量）指南。结果20例患者随机分为两组(对照组：女性16例，男性4例，平均年龄57.6岁；试验：女性9名，男性11名，平均年龄54.2岁。ISTA和DSTA组口腔软组织剖面的平均变化分别为- 0.251和0.083 mm。DSTA的平均差异为- 0.318 mm，差异无统计学意义（95% CI: - 0.860 ~ 0.224, p = 0.241）。ISTA和DSTA的中位面中凹陷分别为- 0.200和- 0.350 mm。ISTA患者0.200 mm的中位数差异不显著（95% CI: - 0.210 ~ 0.700, p = 0.311）。中、远端乳头萎缩、粉红色审美评分及患者审美满意度在两组间无显著性差异。结论对于颊骨壁完整的患者，IIP术后软组织增强的时机对软组织改变和美观效果无显著影响。试验注册：ClinicalTrials.gov: NCT05537545

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来源期刊

Clinical Implant Dentistry and Related Research 医学-牙科与口腔外科

CiteScore

6.00

自引率

13.90%

发文量

103

审稿时长

4-8 weeks

期刊介绍： The goal of Clinical Implant Dentistry and Related Research is to advance the scientific and technical aspects relating to dental implants and related scientific subjects. Dissemination of new and evolving information related to dental implants and the related science is the primary goal of our journal. The range of topics covered by the journals will include but be not limited to: New scientific developments relating to bone Implant surfaces and their relationship to the surrounding tissues Computer aided implant designs Computer aided prosthetic designs Immediate implant loading Immediate implant placement Materials relating to bone induction and conduction New surgical methods relating to implant placement New materials and methods relating to implant restorations Methods for determining implant stability A primary focus of the journal is publication of evidenced based articles evaluating to new dental implants, techniques and multicenter studies evaluating these treatments. In addition basic science research relating to wound healing and osseointegration will be an important focus for the journal.