Tissue Dimensional Changes in Single-Tooth Immediate Extraction Implant Placement in the Esthetic Zone: A Retrospective Clinical Study

Purpose: The aim of this study was to evaluate the buccopalatal volumetric tissue change that occurs following flapless single-tooth immediate extraction placement in the esthetic area and to analyze the role of four different variables. Materials and Methods: Patients in need of a single-tooth replacement in the anterior maxillary or mandibular area (premolar to premolar) were recruited for the study. Patients were treated using four different therapeutic modalities: group 1 (healing abutment), group 2 (healing abutment + bone graft), group 3 (provisional restoration), and group 4 (provisional + bone graft). Alginate impressions were taken the day of implant insertion before tooth extraction (T0), at 1 month (T1), at 3 months (T2), and at 6 months (T3). Buccopalatal dimension (BPD) was measured on the study casts at 1, 3, and 5 mm apical to the free gingival margin and compared between T0 and T1 and T2 and T3. Results: Seventy-seven patients were included in the study, 29 men and 48 women with a mean age of 54 years (range: 24 to 76 years), and 80 implants were inserted. Thirteen implants were inserted in group 1, 13 in group 2, 20 in group 3, and 34 in group 4. The BPD contraction was more evident for group 1, smaller in group 2 and group 3, and minimal in group 4. Repeated measures analysis of variance (ANOVA) and post hoc tests were used. The data analyzed were considered statistically significant with a level of α = .05. The interaction effect P value was numerically zero. Conclusion: The results of this study seem to indicate that volumetric tissue changes after immediate extraction placement in the esthetic area can be minimized if a provisional is immediately connected and a bone graft is inserted simultaneously. Keywords: flapless, immediate implant placement, single tooth, tissue dimensional changes