A randomized controlled trial to compare aesthetic outcomes of immediately placed implants with and without immediate provisionalization

Abstract

Introduction: There are mixed results regarding the aesthetic advantage of immediate provisionalization of dental implants. Therefore, this study aimed to compare facial mucosal level of single immediately placed implants with and without immediate provisionalization. Methods: Single implants were immediately placed to replace a hopeless maxillary anterior or premolar tooth in 40 subjects. Each implant was randomly assigned to receive a non-occluding temporary crown or a healing abutment after implant placement. At 4 months, these implants were permanently restored and followed up for 12 months. Clinical and radiographic parameters were measured and compared. Results: The implant survival rate at 12 months in the test and control group was 90% and 100%, respectively. Mid-facial mucosal marginal level and papilla height changes were minimal within groups, and no significant differences were found between the two groups. The amount of marginal bone remodelling was modest, with no significant difference between the two groups. Radiographic bone changes were not statistically different between the groups, except for the vertical crestal bone resorption. Conclusion: Immediate implant placement with or without provisionalization can achieve stable vertical soft tissue level for 12 months as compared to pre-extraction level. However, immediate provisionalization was not able to improve the aesthetic outcome further.