Method: Thirty patients (9 males, 21 females) with an age range of 20 – 78 years, with immediately placed and restored implants were included in the study. All participating patients underwent the same treatment strategy that involved removal of the failed tooth, flapless surgery, immediate implant placement, grafting of the implant-socket gap and connection of a screw-retained provisional restoration. An intact socket wall and primary stability >30Ncm-1 was a pre-requisite for proceeding with the treatment protocol. Three months following implant placement, the temporary crowns were replaced by the definitive restorations Radiographs and photographs were taken before implant placement (baseline) and at follow-up appointments to measure hard and soft tissue changes around implants. Jemt’s papilla index was used to assess the papillary fill at follow-up appointments.
Result: All implants remained osseointegrated during the follow up period of 2-7 years (mean 49 ± 18 months). Changes in the mesial and the distal papilla were less than 0.5 mm. Mid-facial gingival recession was also limited; the mean scores being less than 0.7mm. Papilla index scores were also favourable with more than 50% of the mesial and distal papillae achieving a score of 3 for a complete papilla.
Conclusion: The study results suggest that, in addition to a favourable implant success rate and peri-implant bony response, the soft tissue levels around single immediately placed implants can also be maintained when proper three-dimensional implant positioning is achieved and bone is grafted into the implant-socket gap.