Effects of Connective Tissue Grafting on the Facial Gingival Level Following Single Immediate Implant Placement and Provisionalization in the Esthetic Zone: A 1-Year Randomized Controlled Prospective Study

Purpose: This 1-year randomized controlled prospective study evaluated the implant success rate and periimplant tissue response following single immediate implant placement and provisionalization (IIPP) with and without subepithelial connective tissue graft (SCTG) in the esthetic zone. Materials and Methods: Implants were placed either IIPP with SCTG (test group) or IIPP without SCTG (control group). The implants were evaluated both clinically and radiographically before surgery, immediately after implant placement, and 3, 6, and 12 months after implant placement. Data were analyzed using Friedman, Wilcoxon signed-rank, and Mann-Whitney U tests at the significance level of α = .05. Results: Twenty implants (10 test, 10 control) were placed in 20 patients (7 men, 13 women) between the ages of 27 and 87 (mean age, 52.6 years). At 1 year, all implants remained osseointegrated, with overall mean marginal bone changes of -0.01 mm and -0.14 mm for the test and control groups, respectively. Mean facial gingival level change was significantly more pronounced in the control group (-0.70 mm) than in the test group (-0.25 mm). The modified Plaque Index scores showed that patients were able to maintain a good level of hygiene throughout the study. At 1 year, the Papilla Index indicated that more than 50% papilla fill was observed in 75% of the test sites and 80% of the control sites. Conclusions: Within the limitations of this study, SCTG was shown to be beneficial in maintaining facial gingival level when performed in conjunction with IIPP procedures. Keywords: esthetics, esthetic zone, gingival biotype, gingival recession, immediate loading, immediate provisionalization, immediate tooth replacement, papilla