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The major advantages of immediate implant insertion are a reduced treatment time, a fewer number of sessions and the minimally invasive procedure. In contrast to the mainstream findings it has been shown in previous reports that immediate implant installation is even successful even when the facial bony wall is defect or absent.
The aim of this case series is to prove a new surgical approach through a combination of immediate implant installation, immediate provisionalization and immediate facial reconstruction by autogenous bone and connective tissue grafting in situations with facial bone deficiencies and severe gingival recessions.
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Methods and Materials: Eight patients mean age Implants were aligned in contact to and slightly below the palatal bony wall of the extraction sites. Connective tissue grafts were harvested from the palate.
In the recipient sites a tunnel was created by intrasulcular incisions at the implant and adjacent teeth sites and supraperiostal preparation without any vertical incisions or papilla separations.
The connective tissue grafts were placed within the tunnel and covered by the coronal positioned split flap.
Facial gaps between implant surface and the connective tissue grafts were grafted with autogenous bone chips. All implants were immediately provisionalized with a temporary crown without occlusal contacts. Implants in diameters 3.
Implant success rates, marginal bone levels, mucogingival changes and the Pink Esthetic Score PES were assessed per implant. Seven implants were placed in the anterior maxilla 2 canines, 5 incisors and one in the anterior mandible 1 incisor. The mean follow-up period was 23 months range months.
CB-CTs were recorded preoperatively and at the final examination. The preoperative distance from the cemento-enamel junction to the marginal bone level was 8. The mean PES ratings improved significantly bronze grail binäre optionen strategie pre-op 8.
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Mean pre-op gingival recession of the condemned teeth was 4. The height of the mucosal recession at the implant sites improved significantly to 1.
Conclusions: Within the limitations of this case series, single teeth rehabilitation patients can be treated with a favorable esthetic outcome, improved mucogingival conditions and stable marginal bone levels using the immediate implant placement and provisionalization approach even when facial bony defects and severe gingival recessions have to be reconstructed by autogenous bone and connective tissue grafting at the same time.