Gingival margin changes in maxillary anterior sites after single immediate implant placement and provisionalization: a 5-year retrospective study of 47 patients.

PURPOSE: To evaluate gingival margin changes in the esthetic zone after immediate implant placement and provisionalization over 5 years with a custom anatomic provisional abutment.

MATERIALS AND

METHODS

Single maxillary incisor immediate implant placement and provisionalization procedures, completed and followed between February 2006 and August 2006, were analyzed retrospectively. During clinical recalls at 3 months, 1 year, and 5 years, changes in gingival margins were recorded with clinical photographs and recorded in millimeters.

RESULTS

Forty-seven patients each received a single implant (19 central incisors, 28 lateral incisors) and were followed for 5 years. Implants and restorations had a 100% survival rate during the study. The mean gingival margin changes (recession) were 0.17 mm at the time of definitive restoration, 0.27 mm at 3 months, 0.30 mm at 1 year, and 0.30 mm at 5 years. After 5 years, 24 of the 47 implant crowns had no significant gingival recession. All central incisor sites received 4.3-mm-diameter implants and had a mean change in tooth length of 0.03 mm at 5 years. Lateral incisor sites (n=28) received either a 3.5-mm-diameter implant (n=20) or a 4.3-mm-diameter implant (n=8). Lateral sites with the 3.5-mm implant had a mean change in gingival margin height of 0.08 mm of tooth length at 5 years; lateral sites with a 4.3-mm platform displayed a mean change of 0.82 mm of tooth length.

CONCLUSION

This study suggests that implant diameter, gingival biotype, surgical technique, and/or the reason for tooth loss can influence the amount of gingival recession occurring over 5 years. Most recession occurred within the first 3 months, between implant placement/provisionalization and definitive restoration. The use of a customized anatomic provisional abutment can reduce the amount and frequency of recession.