Esthetic Outcome of Implants Placed in Fresh Extraction Sockets by Clinicians with or without Experience: A Medium-Term Retrospective Evaluation

Purpose: This study discussed a 3-year retrospective survey of clinical and esthetic outcomes of immediate implants placed by experienced senior surgeons and residents in implant dentistry. Materials and Methods: The retrospective chart review included patients who received single-tooth extraction and immediate implant placement at the Tuscan Stomatology Institute between 2009 and 2011. Treated independent postextraction areas were divided into two groups according to the operator's experience: expert versus nonexpert group. Patient satisfaction with the esthetic aspect, chewing, speaking, comfort, self-esteem, and ease of cleaning were assessed by visual analog scales. Changes in the marginal bone level and parameters describing the changes of the facial soft tissue and in papilla index were assessed. Proper pairwise comparison tests were applied with a significant level α = .05. Results: Of the 60 selected patients, 31 were in the expert group and 29 in the nonexpert group. At the 3-year follow-up, findings attested to a significantly higher bone loss in the nonexpert group (1.74 ± 0.59 mm) than those registered in the expert group (1.34 ± 0.45 mm), with a P value of .0044. The papilla index (PI) appeared very stable in the group of experts, whereas it showed a significant loss throughout the study in patients in the nonexpert group (PI = 2 at 1 year and PI = 1.5 at 3 years). Moreover, significant recessions at the buccal soft tissue were registered for all groups at both check-ups; however, in the expert group, slight soft tissue recession was evident 3 years later (0.58 ± 0.72 mm), whereas the nonexpert group showed greater recession (1.52 ± 0.74 mm). Patients reported higher overall satisfaction when treated by the group of experts (85.2%) than when treated by the nonexperts (81.1%) with P .0001. Conclusion: The findings from this study suggested that immediate implant procedures could be considered a successful and satisfying treatment strategy when strict selection criteria together with a high level of surgical expertise are applied. Palabras clave: clinical competence, delayed dental implant loading, dental prosthesis implant-supported, esthetics dental, single dental implantation