Evaluation of the timing of implant placement in the maxillary esthetic zone A randomized controlled trial

Abstract

Conventionally delayed implant placement has been practiced to prevent post operative complications Immediate implant placement IIP has a growing demand in the maxillary esthetic zone as it is detrimental for esthetic and social wellbeing of the patient However immediate implants can be placed only when the crestal bone thickness CBT is greater than 1mm to prevent complications in hard and soft tissues In clinical scenarios the buccal plate thickness is less than 1mm in maxillary esthetic zone Hence Socket shield technique SST has been widely used to prevent buccal bone resorption However there are no prospective clinical trials available till date comparing the efficacy of these three techniques in terms of changes in CBT soft tissue changes evaluated using the pink esthetic score PES and patient related outcome measures PROMS for esthetic satisfaction and pain perception A total of 75 dental implants were placed in the maxillary esthetic zone 25 implants each in the SST IIP and DIP groups CBCT evaluation was done in all patients pre operatively and at 6 and 12 months for evaluation of changes in the CBT PES was evaluated to assess the changes in soft tissues at the same time points Significant differences in mean reduction in CBT were found between the groups SST group demonstrated lesser reduction in CBT better PES and patient acceptance compared to the IIP and DIP groups This is a clinically relevant information that could be employed in clinical scenarios where implants are to be placed in the esthetic maxillary zone newline