Journal of pharmacy & bioallied sciences · 2025
Impact of Periodontal Biotype on the Long-Term Esthetics of Implant-Supported Restorations: A 5-Year Prospective Study.
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Parihar Anuj Singh, Nandanan Nimisha, Kurien Vino Tito V, Bandgar Subhash, Patri Gaurav, Laddha Rashmi, Kumar Santosh
Аннотация
BACKGROUND: The periodontal biotype is a crucial factor influencing the esthetic outcome of implant-supported restorations. This prospective study evaluated the long-term impact of periodontal biotype on the esthetic stability of single-tooth implant-supported restorations in the anterior maxilla over a 5-year period, with a specific focus on the influence of platform-switching and immediate provisionalization.
METHODS: Patients with a single missing tooth between the maxillary canines requiring implant placement were included. Periodontal biotype was assessed at baseline using the established criteria of probing depth ≤3 mm and gingival thickness ≥2 mm for thick biotype. All patients received Straumann Bone Level implants with a platform-switched design. Immediate provisionalization was performed following implant placement. Esthetic outcomes were evaluated annually for 5 years using the Pink Esthetic Score (PES) and White Esthetic Score (WES). Changes in soft tissue parameters, including gingival recession, papilla height, and mucosal level changes, were also recorded.
RESULTS: A total of 86 patients (45 thick biotype, 41 thin biotype) were included. At 5 years, both biotypes demonstrated remarkably stable esthetic outcomes with consistently high PES and WES scores. However, the thin biotype exhibited significantly greater mean gingival recession (1.2 mm vs. 0.5 mm, P < 0.05) and a higher incidence of mucosal level changes (17% vs. 4%, P < 0.05) compared to the thick biotype. Papilla height remained stable in both groups.
CONCLUSIONS: While both thick and thin biotypes demonstrated acceptable esthetic outcomes at 5 years with platform-switched implants and immediate provisionalization, thin biotype was associated with increased susceptibility to gingival recession and mucosal level changes. These findings underscore the crucial role of meticulous soft tissue management and individualized treatment planning in patients with thin biotypes. They are key to achieving optimal long-term esthetic results in implant dentistry and highlight the significance of your role as a dental professional.
METHODS: Patients with a single missing tooth between the maxillary canines requiring implant placement were included. Periodontal biotype was assessed at baseline using the established criteria of probing depth ≤3 mm and gingival thickness ≥2 mm for thick biotype. All patients received Straumann Bone Level implants with a platform-switched design. Immediate provisionalization was performed following implant placement. Esthetic outcomes were evaluated annually for 5 years using the Pink Esthetic Score (PES) and White Esthetic Score (WES). Changes in soft tissue parameters, including gingival recession, papilla height, and mucosal level changes, were also recorded.
RESULTS: A total of 86 patients (45 thick biotype, 41 thin biotype) were included. At 5 years, both biotypes demonstrated remarkably stable esthetic outcomes with consistently high PES and WES scores. However, the thin biotype exhibited significantly greater mean gingival recession (1.2 mm vs. 0.5 mm, P < 0.05) and a higher incidence of mucosal level changes (17% vs. 4%, P < 0.05) compared to the thick biotype. Papilla height remained stable in both groups.
CONCLUSIONS: While both thick and thin biotypes demonstrated acceptable esthetic outcomes at 5 years with platform-switched implants and immediate provisionalization, thin biotype was associated with increased susceptibility to gingival recession and mucosal level changes. These findings underscore the crucial role of meticulous soft tissue management and individualized treatment planning in patients with thin biotypes. They are key to achieving optimal long-term esthetic results in implant dentistry and highlight the significance of your role as a dental professional.