Immediate supracrestal implant placement with immediate temporization in the anterior dentition: a retrospective study of 31 implants in 26 patients with up to 5.5-years follow-up.

Aim: To assess the stability of the peri-implant bone, the peri-implant soft tissues and the esthetic success of immediately placed implants.

Materials And Methods: In this retrospective study, scalloped-shaped implants were placed immediately and 1.5 mm supracrestally after single-tooth extraction. All implants were immediately restored with an implant-supported temporary crown. Clinical and radiographic parameters were assessed on the day of tooth extraction with subsequent implant placement and temporization, after 6 months at delivery of the final crown, and after 1, after 3, and up to 5 years after crown delivery.

Results: All 31 implants were clinically successful and in function during the observation period (mean 3.4 years). The peri-implant soft tissues were clinically healthy as indicated by a low mean plaque (below 0.5) and sulcus bleeding index (below 0.24) values. The distance between the implant shoulder and the first visible bone-to-implant contact (DIBrx) was measured at the mesial and distal aspects of each implant using periapical radiographs. Mean values for DIBrx of 1.73 ± 0.59 mm directly after implant placement and 2.25 ± 0.66 mm after the observation period demonstrated stable peri-implant bone levels. The mean distance from the implant shoulder to the gingival margin on the labial aspect (DIM vestibular) was 2.21 ± 1.09 mm directly after implant placement. Respective values at 1 year, at 3 years and at 5 years after crown delivery remained stable thus demonstrating little if any gingival recession. The assessed mean values for the pink (PES) and white (WES) esthetic score (0 = 0-33% score, 1 = 34-66% score, 2 = 67-100% score) were 8/4 directly after implant placement and 9/10 after 1.5-5.5 years of observation.

Conclusions: After an observation time of 1.5-5.5 years all implants demonstrated very stable soft tissue levels with little if any recession on mesial, distal and labial aspects and an esthetic score that was reasonable directly after temporization and developed toward maximum scores over time.