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The International Journal of Oral & Maxillofacial Implants
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Int J Oral Maxillofac Implants 29 (2014), No. 1     14. Feb. 2014
Int J Oral Maxillofac Implants 29 (2014), No. 1  (14.02.2014)

Page 127-134, doi:10.11607/jomi.3124, PubMed:24451863


Gingival Margin Changes in Maxillary Anterior Sites After Single Immediate Implant Placement and Provisionalization: A 5-Year Retrospective Study of 47 Patients
Ross, Scott B. / Pette, Gregory A. / Parker, William B. / Hardigan, Patrick
Purpose: To evaluate gingival margin changes in the esthetic zone after immediate implant placement and provisionalization over 5 years with a custom anatomic provisional abutment.
Materials and Methods: Single maxillary incisor immediate implant placement and provisionalization procedures, completed and followed between February 2006 and August 2006, were analyzed retrospectively. During clinical recalls at 3 months, 1 year, and 5 years, changes in gingival margins were recorded with clinical photographs and recorded in millimeters.
Results: Forty-seven patients each received a single implant (19 central incisors, 28 lateral incisors) and were followed for 5 years. Implants and restorations had a 100% survival rate during the study. The mean gingival margin changes (recession) were 0.17 mm at the time of definitive restoration, 0.27 mm at 3 months, 0.30 mm at 1 year, and 0.30 mm at 5 years. After 5 years, 24 of the 47 implant crowns had no significant gingival recession. All central incisor sites received 4.3-mm-diameter implants and had a mean change in tooth length of 0.03 mm at 5 years. Lateral incisor sites (n = 28) received either a 3.5-mm-diameter implant (n = 20) or a 4.3-mm-diameter implant (n = 8). Lateral sites with the 3.5-mm implant had a mean change in gingival margin height of 0.08 mm of tooth length at 5 years; lateral sites with a 4.3-mm platform displayed a mean change of 0.82 mm of tooth length.
Conclusion: This study suggests that implant diameter, gingival biotype, surgical technique, and/or the reason for tooth loss can influence the amount of gingival recession occurring over 5 years. Most recession occurred within the first 3 months, between implant placement/provisionalization and definitive restoration. The use of a customized anatomic provisional abutment can reduce the amount and frequency of recession.

Keywords: dental implants, esthetics, gingival biotype, gingival recession, immediate implant placement, immediate loading, immediate provisionalization