Impact of immediate restoration on bone remodeling in the esthetic zone: A randomized clinical trial.

BACKGROUND/PURPOSE: Traumatic loss of anterior teeth creates esthetic challenges and often requires immediate rehabilitation. Although immediate implant placement and restoration (IIPR) shortens treatment time, strict primary stability limits its use. A native-crown restoration supported by fiber-reinforced composite (FRC) splints may broaden the indications of immediate restoration, but its effectiveness remains unclear. This randomized controlled trial aimed to evaluate the effects of the novel immediate restoration following IIP on peri-implant bone remodeling in anterior esthetic zone trauma during osseointegration.

MATERIALS AND

METHODS

Twenty participants undergoing IIP in the anterior maxilla were randomized into two groups. In the experimental group, immediate restorations were performed using patients' native crowns stabilized with FRC splints, while the control group received conventional delayed restorations. Peri-implant bone remodeling was quantitatively assessed through cone-beam computed tomography (CBCT) at baseline and 4-5 months postoperatively. Secondary outcomes included gingival healing and implant stability quotient (ISQ).

RESULTS

Both groups achieved 100% implant survival. Complete soft tissue closure occurred within 4-5 months in all cases, with no significant intergroup differences. Similarly, no significant intergroup differences were found in peri-implant bone changes at the implant neck (P= 0.878) or 2 mm apically (P= 0.667). Mean ISQ values (Experimental: 75.6 ± 2.4; Control: 74.1 ± 3.4) showed no significant intergroup difference (P= 0.271).

CONCLUSION

The FRC-splinted immediate restoration protocol did not demonstrate additional adverse effects on early peri-implant bone remodeling or osseointegration within the observation period. It may offer an alternative option for immediate esthetic rehabilitation following IIP, particularly in cases where primary stability is limited.