Linda Grütter

Stability of Contour Augmentation and Esthetic Outcomes of Implant‐Supported Single Crowns in the Esthetic Zone: 3‐Year Results of a Prospective Study With Early Implant Placement Postextraction

BACKGROUND Early implant placement is one of the treatment options after tooth extraction. Implant surgery is performed after a healing period of 4 to 8 weeks and combined with a simultaneous contour augmentation using the guided bone regeneration technique to rebuild stable esthetic facial hard- and soft-tissue contours. METHODS In this prospective study, 20 patients were treated with an implant-born single crown and followed for 3 years. Clinical, radiologic, and esthetic parameters were recorded to assess treatment outcomes. RESULTS At the 3-year examination, all 20 implants were successfully integrated, demonstrating ankylotic stability and healthy peri-implant soft tissues as documented by standard clinical parameters. Esthetic outcomes were assessed by the pink esthetic score (PES) and white esthetic score (WES) and confirmed pleasing results overall. WES values were slightly superior to PES values. Periapical radiographs showed minimal crestal bone loss around used bone-level implants with a mean bone loss of 0.18 mm at 3 years. Only two implants revealed bone loss between 0.5 and 1.0 mm. One of these implants had minor mucosal recession <1.0 mm. CONCLUSIONS This prospective study evaluates the concept of early implant placement and demonstrated successful tissue integration for all 20 implants and stable bone-crest levels around implant-abutment interfaces according to the platform-switching concept. The midterm 3-year follow-up revealed pleasing esthetic outcomes and stable facial soft tissues. The risk of mucosal recession was low, with only one patient showing minor recession of the facial mucosa. These encouraging results need to be confirmed with a 5-year follow-up examination.

Masseter muscle thickness, chewing efficiency and bite force in edentulous patients with fixed and removable implant‐supported prostheses: a cross‐sectional multicenter study

OBJECTIVES Edentulous patients may be restored with conventional dentures (C/C), implant-supported overdentures (IOD) or implant-supported fixed dental prostheses (IFDP). Null-hypotheses: chewing efficiency, maximum voluntary bite force (MBF) and masseter muscle thickness (MMT) are lower in patients with C/IOD compared with the patients with bimaxillary IFDPs. Both groups perform better than C/C and are inferior to fully dentate controls. MATERIAL AND METHODS Ethical approval was obtained. For this multicenter cross-sectional study, 80 patients were recruited. Four groups of different dental states comprised of either implant-supported prostheses (C/IOD and IFDP/IFDP) or served as control-groups (C/C and fully dentate D/D). Chewing efficiency was assessed with a two-colour mixing ability test. MBF was measured bilaterally with a force gauge. Two dimensional ultrasonography was used to measure MMT bilaterally. RESULTS Chewing efficiency in C/IOD and IFDP/IFDP (difference NS) was better than in C/C, but not as good as in D/D. MBF in C/IOD was lower than in IFDP/IFDP. Chewing efficiency and MBF were significantly lower in IFDP/IFDP, who had experienced chipping or fracture of the prosthetic superstructure. Median MMT of patients with implant-supported prostheses was between those with C/C and fully dentate participants. There was no significant difference in MMT between C/IOD and IFDP/IFDP. CONCLUSION Supporting complete prostheses with oral implants seems to have positive effects on the thickness of the masseter muscle, maximum bite force as well as chewing efficiency. The type of implant-supported prostheses may have an influence on the magnitude of the effect.

Dimensional changes of peri-implant soft tissue over 2 years with single-implant crowns in the anterior maxilla

OBJECTIVE To compare the peri-implant soft tissue dimensions after insertion of single-implant crowns in the anterior maxilla. MATERIALS AND METHODS Twenty patients were accepted according to well-defined inclusion criteria and randomized to porcelain-fused-to-metal (PFM) or all-ceramic groups. Follow-up was at: Baseline (B), Crown Insertion (CI), 1-year (1Y), and 2-year (2Y). The following parameters were statistically analysed: distance implant shoulder to marginal peri-implant mucosa (DIM), papilla height (PH), width of keratinized mucosa (KM), crestal bone level (CBL), full mouth plaque score (FMPS), full mouth bleeding score (FMBS), and probing pocket depth. RESULTS Between groups measurements for DIM, PH, KM, CBL, FMPS, and FMBS showed no statistically significant differences except the distal CBLs to adjacent tooth. DIM (mid-facial) decreased from B to CI remaining stable at 1Y and 2Y (p-value 0.0014). DIM mesial and distal aspects significantly increased from B to CI showing signs of stability at the 2Y. PH between B and CI increased at the mesial site and at the distal site, thereafter, peri-implant soft tissues were stable at the 2Y. CONCLUSION The insertion of an implant crown affects the peri-implant mucosa morphology by an apical displacement at the mid-facial aspect and coronal at mesial and distal sites.