Immediate Implant Placement and Provisionalization in the Aesthetic Zone Using a Digital Workflow: A 1-Year Prospective Case Series Study

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research Pub Date : 2025-07-24 DOI:10.1111/cid.70079

Vincent J. J. Donker, Gerry M. Raghoebar, Arjan Vissink, Henny J. A. Meijer

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Abstract

Introduction

Immediate implant placement and provisionalization in the maxillary aesthetic zone necessitates meticulous treatment planning. The integration of intraoral scanning with cone beam computed tomography allows for three-dimensional prosthetic-driven planning of the implant. Additionally, it facilitates static computer-assisted implant surgery and prefabrication of a temporary restoration, enabling chairside restoration of the immediate implant. This study aimed to evaluate the clinical, aesthetic, radiographic, and patient-reported outcomes after immediate implant placement and restoration.

Materials and Methods

In a prospective case series, 30 patients with a failing tooth in the maxillary aesthetic zone were included and received immediate implant placement with a bone graft and a prefabricated temporary restoration. The definitive restoration was placed 3 months later. The clinical, aesthetic, radiographic, and patient-reported outcomes were collected prior to implant treatment, 6 weeks after the temporary restoration, and 1 month and 1 year after the definitive restoration.

Results

The prefabricated temporary restoration could be placed in all patients. Three cases of early implant failure were observed (implant survival rate 90%); hence, 27 patients were evaluated after 1 year. The survival and success rates were 100% for the temporary and 100% and 96%, respectively, for the definitive restorations. Plaque, bleeding on probing, and peri-implant inflammation were absent in most cases. At the 1-year follow-up, the mean (SD) Pink Esthetic Score and White Esthetic Score (scale 0–20) was 15.4 (2.5). The mean (SD) marginal bone level change between implant placement and the 1-year follow-up was −0.18 mm (0.57) on the mesial side and −0.44 mm (1.23) on the distal side. The median buccal bone thickness remained stable after immediate implant placement and grafting. The mean (SD) patient satisfaction (scale 0–10) was 9.2 (0.8) at the 1-year evaluation.

Conclusion

The digital workflow has the potential to enable the manufacture of prefabricated temporary restorations, leading to satisfactory clinical, aesthetic, radiographic, and patient-reported outcomes after immediate placement of single-tooth implants in the aesthetic zone.

Clinical Trial Registration

Registered in the National Trial Register (NL8264).

Abstract Image

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使用数字工作流程的美学区立即植入物放置和临时化：1年前瞻性案例系列研究

在上颌美观区即刻植入和预备种植体需要细致的治疗计划。口腔内扫描与锥形束计算机断层扫描的整合允许三维假体驱动种植体的规划。此外，它促进了静态计算机辅助植入手术和临时修复的预制，使即时植入物的椅子旁修复成为可能。本研究旨在评估即刻种植体植入和修复后的临床、美学、放射学和患者报告的结果。材料和方法在前瞻性的病例系列中，包括30例上颌美观区牙齿脱落的患者，并立即接受植骨植入和预制临时修复。3个月后进行了最终修复。在种植体治疗前、临时修复后6周、最终修复后1个月和1年收集临床、美学、影像学和患者报告的结果。结果所有患者均可放置预制临时修复体。观察早期种植体失败3例（种植体成活率90%）；因此，27例患者在1年后进行了评估。临时修复的存活率为100%，最终修复的存活率为100%，成功率为96%。大多数病例无菌斑、探查出血和种植体周围炎症。随访1年，粉色审美评分和白色审美评分（0-20）的平均（SD）为15.4分（2.5分）。种植体放置与1年随访之间的平均（SD）边缘骨水平变化为- 0.18 mm(0.57)，中侧为- 0.44 mm（1.23）。即刻种植和移植后，中颊骨厚度保持稳定。在1年的评估中，患者满意度（量表0-10）的平均（SD）为9.2（0.8）。结论数字化工作流程有可能使预制临时修复体的制造成为可能，在美学区立即放置单牙种植体后，可获得令人满意的临床、美学、放射学和患者报告的结果。临床试验注册在国家试验注册（NL8264）中注册。

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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.