Single implant treatment in healing versus healed sites of the anterior maxilla: a clinical and radiographic evaluation.

PURPOSE: The aim was to document the Nobelreplace tapered TiUnite® (Nobel Biocare, Göteborg, Sweden) implant system used by experienced clinicians in daily practice for replacing single maxillary anterior teeth and to compare the clinical and radiographic outcome between implants installed in healing sites (early implant placement) and fully healed sites (conventional implant placement) after on average two and a half years of function.

MATERIAL AND METHODS: A cross-sectional study in patients who had been treated by two periodontists and two prosthodontists in 2006 and 2007 was conducted. Surgical treatment involved standard flap elevation without releasing incisions and restorative procedures included cemented crowns in all patients. Only straightforward single implant treatments in healing sites (6-8 weeks following tooth extraction) and fully-healed sites (≥6 months following tooth extraction) were considered with both neighboring teeth present and without the need for hard and/or soft tissue grafting. Clinical and radiographic analyses of all implants were performed by a blinded clinician who had not been involved in the treatment.

RESULTS: Forty-nine of the 53 eligible single implants (22 early and 27 conventionally placed implants) in 44/48 patients were available for scrutiny. There was no significant difference in implant survival between early (95%) and conventionally (93%) installed implants (p = 1.000). Mean bone level to the implant-abutment interface was 1.25 and 1.02 mm for early and conventional implant placement, respectively (p = .220). In spite of fairly low plaque levels (26%), overall peri-implant bleeding was quite prevalent (36%). Mean peri-implant probing depth was 3.3 mm. Five restorations had experienced technical complications.

CONCLUSIONS: Single Nobelreplace tapered TiUnite® implants installed in healing as well as in healed sites of the anterior maxilla are predictable. Both strategies seem equally successful in terms of implant survival, bone remodeling, clinical response, and risk for complications.