Single-Tooth Replacement in the Anterior Maxilla by Means of Immediate Implantation and Provisionalization: A Review

Objectives: The objective of this study was to assess to what extent the outcome of immediate implantation and provisionalization for replacing single maxillary teeth in the esthetic zone is favorable and predictable from biologic and esthetic points of view. Material and Methods: An electronic search (MEDLINE and Cochrane Oral Health Group Specialized Trials Register) and a manual search were performed to detect studies concerning maxillary single-tooth replacements by means of dental implants immediately placed into fresh extraction sockets and provisionalized within the first 24 hours. Only full-text reports on clinical studies published in English up to June 2006 were included. Case reports and reviews on the topic of interest were excluded. Results: Eleven studies were selected. Based on a qualitative data analysis, implant survival and even management of papilla levels seem predictable following immediate implantation and provisionalization. However, maintaining the midfacial gingival margin may be more problematic, since postextraction bone remodeling and therefore marginal gingival changes will occur irrespective of the timing of the placement of an implant. The long-term impact of this remodeling is currently unclear and needs to be elucidated in future research. Conclusion: The clinician is recommended to be reserved when considering immediate implant placement and provisionalization for replacing single maxillary teeth in the anterior zone. At the very least, a number of guidelines and prerequisites need to be taken into consideration. Parole chiave: immediate implantation, immediate loading, maxilla, single-tooth dental implants