BACKGROUND Immediate implant placement in the presence of intact extraction alveoli has frequently been reported, while hardly any reports on immediate implant placement in missing buccal bone can be found in literature. OBJECTIVES This pilot study evaluates esthetic outcome and soft and hard tissue level changes of immediate implant placement with immediate provisionalization in patients with partially/completely missing buccal bone without any further augmentation procedure in the maxillary anterior zone. MATERIAL AND METHODS Twelve patients (TG) with partially to completely missing buccal bone designated for extraction and flapless immediate implant insertion in the anterior zone of the maxilla were included. Patients randomly selected out of a larger group of patients with immediate implants with intact alveoli served as controls (CG). Immediate provisionalization was done without any further augmentation of the alveolar ridge. Marginal hard and soft tissue levels, PES, and implant success were evaluated during a 1-year observation period. RESULTS The defect of the buccal alveolar bone was 4.96 mm (min., 2.26 mm; max., 9.68 mm) and the mean mesio-distal extension 4.25 mm (min., 3.2 mm; max., 5.91 mm). Preoperative PES differed significantly between TG (9.68) and CG (12.25) and improved in TG postoperatively with no significant difference to CG after 1 year (TG, 10.91; CG, 11.3). The buccal soft tissue level remained almost unchanged over the observation period (TG preop, 0.86 mm ± 0.90 mm; 1 year, 0.91 mm ± 0.96 mm; CG preop, 0.98 mm ± 0.87 mm; 1 year, 0.98 mm ± 0.87 mm and did not show any correlation with either the mesial/distal bone level or the initial buccal vertical defect at any point of time. CONCLUSIONS These clinical results provide evidence that immediate implant placement without additional augmentation, but with immediate provisionalization might be a viable treatment alternative even with missing buccal plate in the esthetic maxillary zone.

中文翻译：

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牙龈退缩行为，即刻在前上颌中植入种植体，颊裂开裂，无需额外的隆突-一项先导研究。

背景技术已经有完整的拔出牙槽骨存在时立即植入植入物的报道，而文献中几乎没有关于缺失颊骨中植入植入物的报道。目的这项初步研究评估了部分/完全缺失颊骨而无需在上颌前区进行任何进一步增强手术的患者，即刻临时植入并立即进行临时植入的美学效果以及软，硬组织水平的变化。材料与方法纳入十二名患者（TG），其中部分或部分完全缺失的颊骨被指定用于拔牙，并在上颌骨前部无瓣的立即植入种植体。从一大批完整肺泡即刻植入的患者中随机选择患者作为对照（CG）。立即进行临时固定，无需进一步扩大牙槽。在1年的观察期内评估了硬，软组织的边缘水平，PES和植入成功率。结果颊侧牙槽骨缺损为4.96毫米（最小2.26毫米；最大9.68毫米），平均近中距伸展为4.25毫米（最小3.2毫米；最大5.91毫米）。术前PES在TG（9.68）和CG（12.25）之间有显着差异，术后TG改善，一年后与CG无显着差异（TG，10.91; CG，11.3）。颊软组织水平在观察期内几乎保持不变（TG术前为0.86 mm±0.90 mm; 1年为0.91 mm±0.96 mm; CG术前为0.98 mm±0.87 mm; 1年为0.98 mm±0。87 mm，在任何时间点均与中/远端骨水平或初始颊侧垂直缺损均无相关性。结论这些临床结果提供了证据，即刻种植体植入而无需额外的增强，但是即使在美学上颌区颊颊板缺失的情况下，即刻临时植入也可能是可行的治疗选择。