Esthetic Evaluation of Maxillary Anterior Immediate Implant with Provisionalization with or without Bone Grafting

Aim: Immediate implant in the esthetic zone is a treatment of choice.However, much research regarding immediate implant provisionalization lacked in the literature.Hence, our study was conducted with an aim to assess the changes in the soft tissue, hard tissue, and esthetic outcomes following immediate implants with provisionalization with or without bone grafting.Materials and methods: Twenty patients with a mean age between 18 and 55 years referred to the department of periodontology, for immediate implant placement in maxillary anterior region were included in the study.Patients were enrolled into two groups.Group I (test group) included patients with immediate implant placement with provisionalization with bone grafting.Group II (control group) included patients with immediate implant placement with provisionalization without bone grafting.Cement-retained provisional restoration was fitted over temporary abutment for 6 months of healing period.After 6 months of implant placement, definite crown was delivered. Results:The results of our study showed the least resorption of buccal cortical plate and good amount of bone gain in both the groups in terms of horizontal alveolar dimensional changes.The mean amount of horizontal alveolar gain in group I was 1.12 mm at 2 mm, 1.08 mm at 4 mm, and 0.85 mm at 6 mm; in group II, it was 0.97 mm at 2 mm, 1.4 mm at 4 mm, and 0.93 mm at 6 mm. Conclusion:This study showed a significantly better outcome in both the groups in terms of all the parameters when compared from baseline but the mean differences between the two groups were not very significant.The study concluded that immediate implant with provisionalization with or without bone grafting has maintained stability of soft tissues as well as hard tissues and has also given better esthetic outcomes.Clinical significance: The findings of this study proved that immediate implant placement with provisionalization with bone grafting is a predictable treatment modality that maintains the three-dimensional stability of alveolar bone and integrity of soft tissue and gives acceptable esthetics.Hence, this technique promises to fulfill both functional and esthetic concerns of the patient.