Vertical and horizontal dimensional changes of peri‐implant facial bone following immediate placement and provisionalization with customized definite abutment in maxillary anterior single implants

Background Nowadays, immediate implant placement has become a prevalent technique in terms of shortened overall treatment time. However, gingival recession and marginal bone resorption were reported in some studies due to the dis re-connection of temporary abutment which might somehow break the gingiva sealing. Recently, studies demonstrated that using definite abutment could reduce the dimensional changes of bone and soft tissue in posterior region. However, few evidence was published in anterior region Aim/Hypothesis The aim of this study was to evaluate and analyze the vertical and horizontal dynamic dimensional changes to the facial bone following immediate implant placement and provisionalization with customized definite abutment within one year utilizing the cone beam computed tomography (CBCT). Material and Methods 10 implants were delivered into the 10 patients in this study. All implants were immediately installed after teeth were extracted with minimally invasive technique. The customized definite abutments and provisionals were fabricated by using the CAD CAM technique and immediately connected into the implants. CBCT scans taken immediately after surgery (T1) and 1 year after (T2). The mid-sagittal cut of each implant was identified and measurements were made at predetermined levels. Horizontal facial bone thickness (HBT) was measured at 1, 2, 3, 5, 7, 10, 11.5 and 13 mm apical to the implant platform. Vertical facial bone height (VBH) was the perpendicular distance from the implant platform to the most coronal point of the facial bone. Measurements were recorded and dynamic changes within 1 year were evaluated and analyzed. Results Within 1 year, 10 implants with 10 patients were evaluated and analyzed through CBCT scans and no failure implant was observed. For horizontal facial bone thickness at T2 time point, the mean changes were −0.39 mm, −0.54 mm, −0.68 mm, −0.50 mm, −0.48 mm, −0.23 mm, 0.04 mm and 0.10 mm at 1 mm, 2 mm, 3 mm, 5 mm,7 mm, 10 mm, 11.5 mm and 13 mm apical to the implant platform. At all eight different levels, the mean range of horizontal facial bone thickness was from 3.70 mm to 4.38 mm at T1 time point+ At T2 time point, the thickness was from 3.65 mm to 4.32 mm. For the vertical facial bone height at T2, the mean change was 0.42 mm in all implants. Conclusion and Clinical Implications Immediate implant placement and provisionalization with customized definite abutment in maxillary anterior region might be predictable within 1-year observation. The horizonal bone thickness changes were in reasonable ranges and the vertical facial bone height could be further maintained or even enhanced by using this technique.