Immediate placement and provisionalization of implants in the aesthetic zone with or without a connective tissue graft: A 1‐year randomized controlled trial and volumetric study

Abstract Objective To volumetrically compare peri‐implant mid‐facial soft tissue changes in immediately placed and provisionalized implants in the aesthetic zone, with or without a connective tissue graft. Material and methods Sixty patients were included. All implants were placed immediately after extraction. After randomization, in one group, a connective tissue graft (test group, n = 30) was inserted at the buccal aspect of the implant. The other group (control group, n = 30) received no connective tissue graft. Clinical parameters, digital photographs and conventional impressions were obtained before extraction ( T pre ) and at 12 months following definitive crown placement ( T 12 ). The casts were digitized by a laboratory scanner, and a volumetric analysis was performed between T pre and T 12 . Results Twenty‐five patients in each group were available for analysis at T 12 . Volumetric change, transformed to a mean (± SD ) change in thickness, was −0.68 ± 0.59 mm (test) and −0.49 ± 0.54 mm (control) with a non‐significant difference between groups ( p = .189). The mid‐facial mucosa level was significantly different between both groups ( p = .014), with a mean (± SD ) change of +0.20 ± 0.70 mm (test) and −0.48 ± 1.13 mm (control). The Pink Esthetic Score was similar between both groups. Conclusions The use of a CTG in immediately placed and provisionalized implants in the aesthetic zone did not result in less mucosal volume loss after 12 months, leading to the assumption that a CTG cannot fully compensate for the underlying facial bone loss, although a significantly more coronally located mid‐facial mucosa level was found when a CTG was performed.