Clinical Outcome and Patient Satisfaction Following Full-Flap Elevation for Early and Delayed Placement of Single-Tooth Implants: A 5-year Randomized Study

Purpose: This 5-year follow-up report presents the outcome of early and delayed placement of single-tooth implants. Materials and Methods: An implant was placed on average 10 days after tooth extraction in 23 patients (early) and 3 months after tooth extraction in 22 patients (delayed). All implants were placed in the anterior or premolar regions of the maxilla or mandible. Survival rates, prosthodontic complications, probing pocket depths (PPDs), marginal bone levels measured on radiographs (MBLs), soft tissue appearance (papilla dimensions and clinical crown height), and patient satisfaction were evaluated during an observation period of 5 years. Several patients with prior generalized gingival recession were included in the study, and modification of the papilla scoring was made in these cases. Results: Two implants in the early group and 1 in the delayed group failed before occlusal loading. No further implants were lost during the follow-up period. The mean PPD varied from 3.3 to 4.5 mm in the early group and from 3.6 to 4.4 mm in the delayed group 5 years after implant placement. During the 5-year period, an annual marginal bone loss of less than 0.2 mm was found in both groups. Although the early group performed slightly better than the delayed group as to soft tissue appearance just after seating of the implant restoration, the papilla dimensions and the clinical crown height improved spontaneously over time, and no significant differences between the 2 protocols were seen after 5 years. Furthermore, patients in both groups were highly satisfied with the outcome of their implant treatment. Conclusion: The outcomes of early and delayed placement of single-tooth implants were comparable in terms of high survival rates, few prosthetic complications, acceptable MBLs and PPDs, as well as soft tissue appearance and patient satisfaction during a 5-year follow-up period. Keywords: delayed implant placement, early implant placement, patient satisfaction, prosthetic complications, soft tissue appearance