Simultaneous implant placement and restoration with guided bone regeneration in the mandibular anterior region

Restoring the mandibular anterior teeth by implants can be difficult due to potential complications arising from using prosthetic implant connections that are larger than the incisors at the cementoenamel junction level.

This retrospective study is aimed at determining the survival and esthetic outcomes of anterior mandible implants immediately placed and restored in patients diagnosed with stages 3-4 periodontitis. The study included 75 implants that were inserted along with guided bone regeneration in 42 patients. Over a follow-up period of 3 to 8 years (mean of 6.95 ± 1.78 years), the study evaluated esthetic, marginal bone loss (MBL), and biological and prosthetic complications.

No failures were recorded during the follow-up period; after eight years, the survival rate was 100%. Patient's age and gender did not have a statistically significant impact on MBL, but smokers had a greater MBL than non-smokers at the 8-year (2.98 mm vs. 1.23 mm, respectively, p = 0.016) time-point. At 3 years, only 13.3% of the implants had mesial papillae, 36.0% had distal papillae, and 16.0% had the cervical metallic part of the abutment exposed. Peri-implantitis was diagnosed in 20.7% of the patients at the 8-year follow-up time.

Based on the limitations of this study, immediate placement and restoration of the mandibular incisors can be a feasible procedure, but only a few implants achieved the complete restoration of the papillae.