RESUMEN
BACKGROUND: Rehabilitation in the anterior region requires specific conditions for success, such as the presence of papilla, emergence profile, and balance between pink and white esthetic. OBJECTIVES: This systematic review aimed to evaluate the esthetic risk associated with immediate implant placement with immediate restoration in the anterior superior area, where the facial bone plate may be absent or deficient. MATERIAL AND METHODS: The search was done in PubMed, Embase, Cochrane, Lilacs, Scopus, Scielo, and Google Scholar databases. The investigation involved clinical studies and observational studies published between January 2012 and July 2023. Studies were excluded if there was less than 12-month follow-up, no immediate restoration or facial defect, heavy smokers, or systemic disease. The risk of bias was assessed using the ROBINS-I and Modified-Cochrane RoB tools. RESULTS: Twelve studies were included in this systematic review. The thinner the facial plate, the higher the alveolus's risk of gingival recession or shrinkage. There was an increased interproximal recession when the thin phenotype was associated with flap surgery. An increase in pink esthetic score (PES) was reached when immediate implant placement (IIP) and immediate restoration were done. Soft tissue augmentation achieved more gingival-level stability. Regardless of the initial phenotype, an esthetic outcome was delivered. The risk of bias was high in 1 study and moderate in 3 studies. CONCLUSION: It is possible to conclude that esthetic results and increased final PES or patient satisfaction index in IIP treatments associated with immediate restoration could be obtained even in buccal bone wall defects or gingival recession, regardless of their extension.
RESUMEN
BACKGROUND: There is lack of studies regarding preservation and possible changes in BBT at dental implants. PURPOSE: To assess, on cone beam computer tomograms, the presence of bone at the time of tooth extraction in the maxillary esthetic region and the mean buccal bone thickness 1 month and 1 year after final restoration placement in patients with large bony defects. MATERIAL AND METHODS: In a cohort study, patients were selected presenting a failing tooth with a large bony defect (test group [n = 20]: large bony defect, immediate placed implant and delayed provisionalization). Results were compared with a group in which patients presented a failing tooth without or with a small bony defect: (control group [n = 20]: without or small bony defect, immediate placed implant and delayed provisionalization). Cone beam computer tomograms were made preoperatively, and 1 month and 1 year after placement of the restoration, and buccal bone thickness was analyzed. RESULTS: In both groups approximately 1 mm of buccal bone thickness was present after 1 month and 1 year, without a significant difference between the groups. CONCLUSION: In patients with large bony defects at a failing tooth it was possible to create a bone layer buccally of the implant and this bone layer remained stable during a 1-year follow-up; there were no significant differences between thickness of buccal bone at 1 month and 1 year in patients with large buccal bony defects and patients without or with small bony defects.
Asunto(s)
Proceso Alveolar/patología , Carga Inmediata del Implante Dental , Adolescente , Adulto , Proceso Alveolar/diagnóstico por imagen , Mejilla , Tomografía Computarizada de Haz Cónico , Implantes Dentales/efectos adversos , Femenino , Humanos , Carga Inmediata del Implante Dental/efectos adversos , Carga Inmediata del Implante Dental/métodos , Masculino , Maxilar , Persona de Mediana Edad , Adulto JovenRESUMEN
BACKGROUND: Sufficient buccal bone is important for optimal esthetic results of implant treatment in the anterior region. It can be measured with cone beam computed tomography (CBCT), but background scattering and problems with standardization of the measurements are encountered. The aim was to develop a method for reliable, reproducible measurements on CBCTs. METHODS: Using a new method, buccal bone thickness was measured on ten CBCTs at six positions along the implant axis. Inter- and intraobserver reproducibility was assessed by repeated measurements by two examiners. RESULTS: Mean buccal bone thickness measured by observers 1 and 2 was 2.42 mm (sd: 0.50) and 2.41 mm (sd: 0.47), respectively. Interobserver intraclass correlation coefficient was 0.96 (95% CI 0.93 to 0.98). The mean buccal bone thickness of the first measurement and the second measurement of observer 1 was 2.42 mm (sd: 0.50) and 2.53 mm (sd: 0.49), respectively, with an intraobserver intraclass correlation coefficient of 0.93 (95% CI 0.88 to 0.96). The mean buccal bone thickness of the first measurement and the second measurement of observer 2 was 2.41 mm (sd: 0.47) and 2.52 mm (sd: 0.47), respectively, with an intraobserver intraclass correlation coefficient of 0.96 (95% CI 0.93 to 0.97). CONCLUSIONS: Applying the methods used in this study, CBCTs are suitable for reliable and reproducible measurements of buccal bone thickness at implants.