Clinical
aesthetic zone Immediate implants in the
In the first of a two-part series of articles, Ronan Allen BDentSc, MS and Edward O’Reilly BDentSc MClinDent look at preserving tissues
T Fig 1
he aesthetic outcome of any single anterior implant restoration is largely dependent on the contours of the
peri-implant hard and soft tissues (Kois JC et. al. 200ı). Advances in abutments and ceramic materials mean that we as clinicians have the ability to mimic life-like resto- rations on a very consistent and predictable level. The challenge we face today
in implant dentistry is trying to place implants in a minimally traumatic, time-efficient fashion
without compromising aesthetics. Therefore, ideally we would like to place implants immediately into extraction sockets with an imme- diate provisional restoration. The literature shows us that
survival rates for immediate implant placement into extrac- tion sockets are as successful as delayed approaches (Kan et al 2003). However, aesthetic risks do exist with this treatment modality especially with respect to mid- facial recession. It has been well documented that most dimensional changes to
bone and soft tissue occur in the first six months after tooth extrac- tion. To overcome this tissue loss, an immediate implant concept was introduced in the late ı990s, in an attempt to preserve the original bucco-lingual contours. Unfortunately, it has been recently
reported that the thin facial plate of the anterior maxilla still undergoes some vertical resorption (Cosyn J et al 20ı2, Araújo MG et al 2005, Fürhauser R et al 2005, Botticelli D, et al 2004). This can be exaggerated
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Fig 3 Ireland’s Dental magazine 17
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