The thickness of labial bone affects the esthetics of immediate implant placement and provisionalization in the esthetic zone: A prospective cohort study.

BACKGROUND

A 1-2 mm thick labial plate is generally advocated in immediate implant placement and provisionalization (IIPP). However, most of the human labial plates fail to meet this requirement.

PURPOSE

This study aimed to investigate the effect of labial plate thickness on hard tissue, soft tissue, and esthetic outcomes in IIPP.

MATERIALS AND METHODS

In this prospective cohort study, 40 patients received IIPP of 50 single-crown implants in the anterior maxilla. Patients were categorized into three groups according to their presurgical thickness of labial bone: 0-0.5, 0.5-1, and ≥ 1 mm. CBCT, mucosa recession and the papilla index were used to analyze labial hard and soft tissue alterations with a 1-year follow-up.

RESULTS

At 1 year, OCI bone losses were 1.17 ± 0.73, 0.37 ± 0.39, 0.46 ± 0.35 mm; ICH bone losses were 2.23 ± 1.83, 0.74 ± 0.71, 0.72 ± 1.27 mm; TM recessions were 1.00 ± 0.51, -0.06 ± 0.37, -0.30 ± 0.88 mm; TL recessions were 0.61 ± 1.02, -0.18 ± 0.40, -0.26 ± 1.15 mm; TD recessions were 0.61 ± 1.02, -0.18 ± 0.40, -0.26 ± 1.15 mm; PIS scores were 1.63 ± 0.64, 2.20 ± 0.71, 2.71 ± 0.57 in group 0-0.5, 0.5-1 and ≥ 1 mm, respectively. No statistical significance was found between group 0.5-1 and ≥ 1 mm in bone resorption, gingival recession, and papilla index. The bone resorption and gingival recession were significantly the highest in group 0-0.5 mm at 6 months and 1 year.

CONCLUSIONS

Group 0.5-1 mm had similar tissue dimensional alteration as group ≥1 mm, while group <0.5 mm suffered more massive bone resorption and gingival recession. Concerning the thickness of the labial plate, this study may suggest an expansion in the indication of IIPP.