Soft & Hard Tissue Assessment around Immediate & Delayed Implants: A Clinico-Radiographical Study

The aim of the modern dentistry is to provide the predictable treatment in short duration. Replacement of missing teeth in shorter duration helps in fulfilling patient's aesthetics and functional demands. Endosseous dental implants are predictable method for replacing missing dentition. The evolution in implant surgical techniques is focused on decreasing treatment duration, e.g. implants can be placed in fresh extraction socket. Therefore, this non-randomized clinical controlled study was designed to determine that whether the treatment outcomes obtained by short treatment duration (immediate implant) are comparable with conventional treatment options (delayed implant) by evaluating the peri-implant soft and hard tissue level, clinically and radiographically {by Cone beam computed tommography (CBCT)}. Total of 30 implants were placed in 13 patients, according to Type 1 ITI protocol (Group 1; 15 implants) and Type 4 ITI protocol (Group 2; 15 implants). Implants in each group were loaded with definitive restoration after 3 months of placement. Hard tissue parameters (marginal bone width and height and probing depth) and soft tissue parameters (width of keratinised gingiva and papillary index) were evaluated at baseline, 3 months post implant insertion and 3 months post prosthetic loading. The results showed statistically significant reduction in width of marginal bone in delayed implants as compared to immediate implants. In contrast, significant reduction in marginal bone height and width of keratinised gingiva was evident in immediate implants. Significant reduction in pocket depth (after 2nd stage surgery and 3 months post prosthetic loading) was noted around delayed implants (p<0.05). Moreover, esthetic results showed regeneration of interproximal papillae in both the groups till the end of study period. This study was concluded that both the groups showed similar results but in some aspects delayed implants was superior to immediate implants. Careful evaluation of implant placement sites before implant installation promotes optimal implant esthetics and survival outcomes.