Facial gingival tissue stability after connective tissue graft with single immediate tooth replacement in the esthetic zone: consecutive case report

Joseph Y K Kan, Kitichai Rungcharassaeng, Taichiro Morimoto, Jaime Lozada
Journal of Oral and Maxillofacial Surgery 2009, 67 (11): 40-8

PURPOSE: The present consecutive case report evaluated facial gingival tissue stability after immediate tooth replacement with connective tissue grafting in the esthetic zone. The implant success rate and peri-implant tissue response were also recorded.

PATIENTS AND METHODS: A total of 20 consecutive patients with a mean age of 52.3 years (range 28 to 71), who had undergone 20 single immediate tooth replacement with connective tissue grafting, were evaluated clinically and radiographically at the preoperative examination, immediately after implant placement and provisionalization with connective tissue grafting, and at the latest follow-up appointment. The data were analyzed using the t test and Wilcoxon signed rank test at a significance level of alpha = .05.

RESULTS: At the preoperative examination, a thick gingival biotype was observed in 8 patients and a thin gingival biotype in 12. At a mean follow-up of 2.15 years (range 1 to 4), all implants were functioning and exhibited a thick biotype. At the latest follow-up appointment, no significant differences (P > .05) were found between the initially thick and thin gingival biotypes in the mean mesial marginal bone level changes (-0.53 versus -0.55 mm), the mean distal marginal bone level changes (-0.50 versus -0.44 mm), and the mean facial gingival level changes (+0.23 mm versus +0.06 mm). The frequency distribution of the papilla index score showed that peri-implant papillae were well preserved at the latest follow-up visit.

CONCLUSIONS: With proper 3-dimensional implant positioning and bone grafting into the implant-socket gap, the facial gingival level can be maintained after connective tissue grafting with single immediate tooth replacement, regardless of the initial gingival biotype, indicating that the thin gingival biotype can be converted to the thick gingival biotype morphologically and behaviorally with this procedure. Nevertheless, careful patient selection and treatment planning, as well as immaculate execution by skillful clinicians, are required to achieve a successful result.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"