Immediate Implant Placement in the Esthetic Zone with Marginal Preservation: Esthetic Outcomes in Sites with Thin Buccal Bone Wall.

Purpose: To assess facial soft tissue levels and buccal bone thickness following immediate implant placement in compromised maxillary anterior sockets using marginal preservation technique.

Materials and methods: A total of 49 patients with failing maxillary anterior teeth were assigned to single immediate implant placement using appropriately sized implants, combined with absorbable collagen matrix membrane and sticky demineralized freeze-dried bone allograft grafting. Definitive crown placement occurred 6 months after provisionalization. The primary outcome was the change in soft tissue levels, assessed using pink esthetic score (PES). Additionally, survival rates and buccal bone thickness were evaluated.

Results: The implant survival rate at 6-month follow-up was 100%. After 6 months, the overall PES significantly increased from 6.16 ± 2.23 to 7.31 ± 0.87 (p = 0.002). There was no statistically significant difference in esthetic outcomes between thick and thin gingival phenotypes. Implants with immediate provisionalization had a higher PES compared to those with delayed provisionalization (7.53 ± 0.76 and 7.04 ± 0.93, respectively, p = 0.041). A positive gain in buccal bone thickness was observed at 6-month post-surgery, and the timing of provisionalization (immediate versus delayed) did not significantly influence buccal bone thickness.

Conclusion: Immediate implant placement combined with a marginal preservation technique resulted in optimized esthetic outcome and positive changes in buccal bone thickness.