wileyonlinelibrary.com/journal/clr Clin Oral Impl Res. 2018;29:346–352.
© 2018 John Wiley & Sons A/S.
Published by John Wiley & Sons Ltd
1 | INTRODUCTION
The increased success and predictability of dental implants have
led to their use in a wide variety of clinical situations, including the
replacement of single missing teeth in the anterior maxilla. With in-
creasing patient demands and expectations, attempts have been made
to shorten the overall treatment period by placing implants immedi-
ately following tooth extraction. Immediate implant placement for
Accepted: 2 December 2017
Clinical and aesthetic outcomes of immediately placed single-
tooth implants with immediate vs. delayed restoration in the
anterior maxilla: A retrospective cohort study
Himanshu Arora | Saso Ivanovski
School of Dentistry and Oral
Health, MHIQ, Griffith University, Gold Coast,
Saso Ivanovski, School of Dentistry and Oral
Health, Menzies Health Institute Queensland,
Griffith University, Gold Coast, QLD, Australia.
Objective: To evaluate the impact of the timing of restoration on clinical and aesthetic
outcomes following immediate implant placement in the maxillary aesthetic zone.
Material and Methods: Forty patients (16 males, 24 females) with a mean age of
50.55 ± 12.79 years (range 19–74) who had a single maxillary anterior tooth replaced
by an immediate implant were included in this study. Twenty patients had their im-
plant restored immediately with a provisional restoration (Group A), while the other 20
patients had a delayed restoration placed after 3–4 months of non- submerged healing
(Group B). Clinical parameters and hard- tissue changes were evaluated after a mean
follow- up period of 3 years. Aesthetic evaluation was carried out using the Pink
Esthetic Score (PES) and the White Esthetic Score (WES).
Results: No significant differences were observed in the bone level changes between
the two groups: 0.05 ± 0.65 mm mesially and 0.06 ± 0.52 mm distally for the immedi-
ate group and 0.30 ± 0.54 mm mesially and 0.21 ± 0.60 mm distally for the delayed
group, respectively. The median PES scores were 11.5 for Group A and 10 for Group
B. Mean PES and WES scores did not differ significantly between Groups A and B: PES
(11.1 vs. 10.3; p = .16) and WES (8.4 vs. 7.8; p = .16). In terms of individual PES varia-
bles, the distal papillae were significantly better in Group A as compared to Group B
(p = .006).
Conclusions: Within the limits of this study, timing of restoration seemed to positively
affect the aesthetic outcomes of immediately placed implants as evidenced by higher
median PES values for the immediate restoration group when compared to the de-
layed restoration group. Restoration timing had no impact on the individual PES vari-
ables, except for the distal papillary height which was superior in the immediate
aesthetics, dental implant, immediate placement and restoration, osseointegration, soft tissue