One-year survival and soft tissue aesthetics of immediately placed implants with immediate provisional crowns for maxillary incisors in patients with or without chronic peri-apical periodontitis: a retrospective study.

Tooth loss in the aesthetic zone, particularly of a maxillary incisor, can substantially affect function, appearance, and patient well-being. Immediate implant placement with provisionalization is widely used, but is traditionally limited to non-inflamed extraction sites. This retrospective cohort study compared the 1-year outcomes of immediately placed dental implants replacing a maxillary incisor in patients with and without chronic peri-apical periodontitis. Clinical records of patients treated between January 2019 and December 2022 were reviewed. Outcome variables included implant survival, preoperative clinical and/or radiological inflammation, primary implant stability measured by the implant stability quotient (ISQ), and peri-implant soft tissue aesthetics assessed using the pink aesthetic score (PES) on standardized pre- and postoperative photographs. A total of 133 implants were included, of which 42 were placed in inflamed extraction sockets and 91 in non-inflamed sockets. After 1 year, implant survival was 97.6% in the inflamed group and 97.8% in the non-inflamed group, with no statistically significant difference (P = 0.96). No significant intergroup differences were observed for ISQ (P = 0.35) or change in PES from baseline to 1 year (P = 0.89). These findings suggest that immediate implant placement for maxillary incisor replacement provides comparable 1 year survival, stability, and aesthetic outcomes.