A short-term clinical evaluation of immediately restored maxillary TiOblast single-tooth implants

The purpose of this study was to evaluate the short-term clinical outcome of single-tooth implants placed in the maxilla and immediately restored using cementless friction-fit temporary crowns.

Twenty-five patients consecutively referred to a private specialist practice for the replacement of failing or missing maxillary teeth were treated by means of immediate temporization of their single-tooth implants. Where teeth were still present, implants were placed immediately following extraction. Provisional crowns were fabricated on a special friction-fit coping by means of autopolymerizing acrylic resin. Definitive crowns were placed a mean of 4.5 months after surgery. Implant survival was recorded along with the level of the marginal bone relative to a fixed reference point 1 year after placement. Any adverse soft tissue changes were also noted.

A total of 28 Astra Tech ST dental implants were placed. The overall survival rate at the end of the study was 96.4% for implants which were in function for periods ranging from 15.7 to 27 months. One patient, a smoker, lost 1 implant within 1 month of surgery. Mean marginal bone loss was 0.40 mm (range 0 to 1.53 mm) 1 year after placement of the implants. Many implants (37.5%) had no observed bone loss. No implants or crowns have been lost during the functional loading period. One implant was associated with an unfavorable recession of soft tissues; however, most maintained an esthetic gingival architecture. Eleven of 28 provisional restorations needed treatment; 6 required replacement during the temporization period, and 5 required cementation because of looseness. The ease of removal of the crowns allowed regular access for irrigation with chlorhexidine and thus maintenance of soft tissue health.

The need to provide provisional restorations for single-tooth gaps often presents challenges. An immediate temporary partial denture or adhesive prosthesis may be unacceptable or impractical. The current study describes a simple method for the immediate temporization of single-tooth implants. The results did not indicate any negative influence on osseointegration or short-term survival once the implants were functionally loaded.

Immediate temporization of maxillary single-tooth implants can be both safe and predictable, and it appears that the procedure can yield favorable soft tissue esthetics.