Methods: Previously treated chronic periodontitis patients, requiring implant therapy and meeting the following criteria, were accepted into this study: 1. Partially edentulous. 2. BOP ≤10% and PlI ≤ 1. Computer guided implant placement was performed, using Med3D software. Impressions were taken immediately post-op. Three days following surgery, a provisional fixed restoration was provided. Peri-implant mucosal measurements were performed at baseline (time of provisional delivery), 4, 12 and 24 weeks. These measurements included: keratinized gingival width (GW), gingival thickness (GT), buccal marginal gingival height (GH) and papilla fill (P%). GT was measured using a 27G needle and a digital caliper. GW, GH and P% were measured using a periodontal probe. Abutments and provisional prosthesis were used as fixed reference points. Student's t-test for paired observation (¦Á=0.05) was used to compare between measurements at the different time points.
Results: Mean±SD P% increased from 34±25.9% at baseline to 42.65±35.1% at 24 weeks, with most changes occurring between weeks 12 and 24 (DP%=11.77, p=0.0068). GW increased from 2.86±1.55mm at baseline to 3.53±1.81mm at 24 weeks, with significant change occurring between baseline and 4 weeks (DGW=0.94mm, p=0.0024). GH decreased from 0.94±0.77mm at baseline to 0.43±0.48mm, with a significant decrease occurring between weeks 4 and 12 (DGH=0.81mm, p=0.001), followed by a significant increase between weeks 12 and 24 (DGH=0.53 mm, p=0.001). GT decreased from 2.78±1.14 at baseline to 2.52±0.96, however this was not statistically significant.
Conclusions: peri-implant mucosa around immediately restored implants changes continuously during 24 weeks following placement. These include: increase of papilla height, reduction in mucosal thickness and increased gingival recession. These phenomena should be taken into account when early fixed restoration is considered, as they might affect the esthetic end-result.