Comparative evaluation of immediate implant placement and provisionalization (IIPP) with and without a concentrated...

The immediate placement of the implant into a fresh extraction socket site with immediate provisionalisation is considered to be a predictable and acceptable procedure. However, there are mixed results regarding the advantages of the immediate provisionalization of dental implants, using a biomaterial in the jump space (JS).

This randomized controlled trial (RCT) aimed to evaluate the use of a concentrated growth factor (CGF)-enriched bone graft in the JS of immediate implant placement with provisionalization (IIPP) in the maxillary esthetic zone.

Forty immediate dental implants were placed with and without a CGF-enriched bone graft in the test and control groups, respectively, along with provisional restorations. The clinical evaluation of the modified plaque index (mPI), the modified sulcular bleeding index (mSBI), the probing depth (PD), the gingival thickness (GT), and the Testori implant esthetic score (TS) was done at baseline, and at 6 and 12 months postoperatively. The assessment of the crestal bone height (CBH), the buccal bone thickness (BBT), the ridge width (RW), the vertical distance (VD), JS, and the radiolucent area (RA) was carried out using cone-beam computed tomography (CBCT) at baseline and 12 months postoperatively. The visual analog scale (VAS) was used to assess pain and patient satisfaction.

Highly significant differences were observed with regard to the change in RW at 4 mm from the crest (9.80 ±0.89 mm), VD-distal (1.35 ±0.43 mm), JS-mesial (0.38 ±0.34 mm), JS-distal (0.25 ±0.34 mm), JS-buccal (0.42 ±0.39 mm), RA-mesial (0.63 ±0.48 mm2), and RA-buccal (0.19 ±0.47 mm2) in the test group as compared to the control group at 12 months. The intergroup comparison for TS showed a statistically significant difference (p < 0.05).

It is recommended to use CGF-enriched bone grafting in JS, along with provisionalization, in the anterior esthetic zone.