Evaluation of the Esthetic Results of 64 Nonfunctional Immediately Loaded Postextraction Implants in the Maxilla: Correlation between Interproximal Alveolar Crest and Soft Tissues at 3 Years of Follow-Up

Purpose: Many authors have emphasized that immediate loading protocols enable better esthetic results to be achieved compared with delayed loading, especially in the case of postextraction implants that are capable of maintaining the original esthetics of soft tissues. The aim of this study was to establish correlations between the interproximal crest, interproximal papilla, and marginal facial gingiva of immediately loaded postextraction implants by evaluating clinical and radiographic data. Materials and Methods: Fifty-eight consecutive patients underwent a tooth extraction and immediate implant placement with 64 postextraction implants, which were immediately loaded using a provisional single crown from June 2005 to December 2006. At 6months after surgery, all implants were restored with a definitive single crown. Clinical and radiographic data were recorded at the time of surgery, at the time of definitive restoration, and after 3years of functioning, in order to evaluate soft tissues esthetics and bone tissue condition. Statistical analysis was used to assess significant correlations between the interproximal crest, interproximal papilla, and marginal facial gingiva (p=0.05). Results: After 3years of functioning, the implant success rate was 100% because no implants had failed. All parameters were stable and steady during the 3-year follow-up. The regression test revealed a statistically significant correlation between interproximal crest levels and interproximal papilla volume (p=0.0134), and also between interproximal crest levels and marginal gingiva levels (p=0.0226). Conclusions: Postextraction immediately loaded implants represent a predictable technique that should be considered the treatment of choice in cases of single anterior tooth restoration and other cases. Esthetic results seem to depend on correct positioning of the implants, considering the correlation between bone tissue and related soft tissues. Maintaining the original condition of both bone and soft tissues around the tooth to be removed is the key to obtaining optimal esthetic outcomes.