IMMEDIATE IMPLANT ON ANTERIOR

POSITION

THREE GROUPS
ITI Consensus Group
Araujo & Lindhe Group
Joseph Kan Group

Proceedings of the Third ITI Consensus Conference, 2003

IJOMI, 2004:19(7S): 26-28

Clin. Oral Impl. Res. 17, 2006; 606614

In human hard tissue, at 6 months

Buccal
-horizontal dimensional reduction : 3.79 0.23 mm

-vertical reduction: 1.24 0.11 mm

Mesial: 0.84 0.62 mm
Distal: 0.80 0.71 mm
Vertical dimensional change: 1122% at 6 months
Horizontal dimensional change: 32% at 3 months, 2963% at 6
7 months.

Soft tissue
0.40.5 mm gain of thickness at 6 months on the buccal
and lingual aspects
Horizontal dimensional changes of hard and soft tissue
(loss of 0.16.1 mm) was more substantial than vertical
change (loss 0.9 mm to gain 0.4 mm) during observation
periods of up to 12 months

Conclusion
Human re-entry studies showed horizontal bone loss of
2963% and vertical bone loss of 1122% after 6 months
following tooth extraction

Int J Periodontics Restorative Dent 2008;28:123135

The presence of Bio-Oss

Collagen failed to inhibit the processes
of modeling and remodeling that took
place in the socket walls following
tooth extraction. However, it apparently
promoted de novo hard tissue
formation, particularly in the cortical
region of the extraction site. Thus, the
dimension of the hard tissue was
maintained and the profile of the ridge
was better preserved.

Clin. Oral Impl. Res. 00, 2014, 16

Joseph Y. K. Kan
J Oral Implantol. 2000;26(1):35-41.
,,,primary closure. Failed
Pract Periodontics Aesthet Dent. 2000 Jun-Jul;12(5):467-74
A flapless implant surgery technique in the anterior maxilla Fine
Pract Periodontics Aesthet Dent. 2000 Nov-Dec;12(9):817-24
A customized temporary abutment and immediate fixed provisionalization Fine
Int J Oral Maxillofac Implants. 2003 Jan-Feb;18(1):31-9.
Favorable implant success rates, peri-implant tissue responses, and esthetic outcomes
can be achieved with immediately placed and provisionalized maxillary anterior
single implants.
J Periodontol. 2003 Apr;74(4):557-62.
Greater peri-implant mucosal dimensions were noted in the presence of a thick periimplant biotype as compared to a thin biotype
Int J Periodontics Restorative Dent. 2003 Jun;23(3):249-59.
Interimplant papilla preservation in the esthetic zone: a report of six consecutive cases

Joseph Y. K. Kan
J Calif Dent Assoc. 2005 Nov;33(11):865-71.
Bilaminar subepithelial connective tissue grafts for immediate implant placement
and provisionalization in the esthetic zone

J Oral Maxillofac Surg. 2007 Jul;65(7 Suppl 1):13-9.

U- and UU-shaped defects showed significantly higher frequency and magnitude
of facial gingival recession (>1.5 mm) when compared with V-shaped defects 1year after immediate tooth replacement and guided bone regeneration.

Int J Oral Maxillofac Implants. 2011 Jan-Feb;26(1):179-87

a 2- to 8-year follow-up:: The effect of gingival biotype on peri-implant tissue
response seemed to be limited only to facial gingival recession and did not
influence interproximal papilla or proximal marginal bone levels.
Int J Periodontics Restorative Dent. 2013 Jan-Feb;33(1):e24-31.
Proximal socket shield for interimplant papilla preservation in the esthetic zone

INT J ORAL MAXILLOFAC IMPLANTS 2003;18:3139

Conclusion: The results of this study suggest that

favorable implant success rates, peri-implant tissue responses,
and esthetic outcomes can be achieved with immediately
placed and provisionalized maxillary anterior single implants.

Clin. Oral Impl. Res., 17, 2006; 351358

Clin. Oral Impl. Res. 19, 2008; 7380

Int J Periodontics Restorative Dent 2007;27:313323.

COIR 2012;14;517-526

Int J Oral Maxillofac Implants 2014;29(Suppl):186215.

Conclusions: Acceptable esthetic outcomes may be achieved with

implants placed after extraction of teeth in the maxillary anterior and
premolar areas of the dentition. Recession of the midfacial mucosa is a
risk with immediate (type 1) placement. Further research is needed to
investigate the most suitable biomaterials to reconstruct the facial bone
and the relationship between long-term mucosal stability and
presence/absence of the facial bone, the thickness of the facial bone,
and the position of the facial bone crest.

J Periodontol 2009;80:163-172.

Conclusions: Immediate implant

placement without elevation of
surgical flaps is associated with
recession of the marginal mucosa
that may fall within the threshold
of visually detectable change.
The orofacial position of the
implant shoulder and the tissue
biotype are important
contributory factors.

1. Flapless
2. Thick biotype
3. Palatal position

1.Thick biotype
2.>1mm buccal bone wall
3.Primary stability (native bone 3-5mm)
4.Flapless
5.Palatal position
6.Subcrestal (B) 1 mm (SubGA 3-4mm)
7.Provisional Restoration
8.Customized abutment

Tooth Extraction

Primary Stability
Implant position

Poor

Good

Early

Immediate

Intact socket
Thick biotype

Y
Flapless

Loading

Flap + GBR
or CT graft

High

Low

Delay

Immediate

Provisions

https://www.for.org/en/video-insights/bernard-touati-anteriorimplant-esthetics-optimal-soft-tissue-integration