• International Journal of Oral Biology
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• v.46 no.4
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• pp.200-207
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• 2021

In case of gingival recession and alveolar bone defects due to tooth loss for a long period of time in a single tooth in the maxillary anterior region, it is not easy to obtain aesthetic results with a single implant prosthesis. For aesthetic restoration, it is important to preserve hard and soft tissues through alveolar bone augmentation as well as restore harmony with adjacent teeth and soft tissues by placing the implant in an ideal location. In this case, an implant was placed using guided bone regeneration and a connective tissue graft simultaneously with immediate implantation after extraction from the maxillary anterior region where only residual root was left for a long period of time.

• The Journal of the Korean dental association
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• v.58 no.2
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• pp.83-92
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• 2020

In the anterior maxillary area, dental implants for tooth replacement are challenging due to the need to satisfy high esthetic level as well as functionality. Immediate implant placement and provisionalization can dramatically reduce the edentulous period, and then fulfill patient's demand for esthetics. The aim of present case report is to demonstrate two cases that successfully restored single tooth with immediate implant placement and provisionalization in the anterior maxillary area. A 47 years old female was scheduled to replace her maxillary right central incisor due to crown-root fracture by trauma. Another 54-year-old female was planned to place dental implant following tooth extraction of maxillary right lateral incisor owing to continuous pus discharge despite repetitive treatments including apicoectomy. In these two cases, surgical and prosthetic procedures progressed in a similar way. After minimal flap elevation, atraumatic tooth extraction was performed. Implant was placed in proper 3-dimensional position and angulation with primary stability. Bone graft or guided bone regeneration for peri-implant bone defect was conducted simultaneously. Provisionalization without occlusal loading was carried out at the same day. Each definitive crown was delivered at 7 and 5 months after the surgery. Two cases have been followed uneventfully for 2 to 5 years of loading time. In conclusion, Immediate implant placement and provisionalization could lead to esthetic outcome for single tooth replacement with dental implant under proper case selection.

• Journal of Periodontal and Implant Science
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• v.40 no.4
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• pp.188-193
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• 2010

Purpose: The aim of this study is to assess the influence exerted by the observer's dental specialization and compare patients' opinion with observers' opinion of the esthetics of maxillary single-tooth implants in the esthetic zone. Methods: Forty-one adult patients, who were treated with a single implant in the esthetic zone, were enrolled in this study. Eight observers (2 periodontists, 2 prosthodontists, 2 orthodontists and 2 senior dental students) applied the pink esthetic score (PES)/white esthetic score (WES) to 41 implant-supported single restorations twice with an interval of 4 weeks. We used a visual analog scale (VAS) to assess the patient's satisfaction with the treatment outcome from an esthetic point of view. Results: In the PES/WES, very good and moderate intraobserver agreements were noted between the first and second rating. The mean total PES/WES was $11.19{\pm}3.59$. The mean PES was $5.17{\pm}2.29$ and mean WES was $6.02{\pm}1.96$. In the total PES/WES, the difference between the groups was not significant. However, in the WES, the difference between the groups was significant and prosthodontists were found to have assigned poorer ratings than the other groups. Periodontists gave higher ratings than prosthodontists and senior dental students. Orthodontists were clearly more critical than the other observers. The statistical analysis revealed statistically significant correlation between patients' esthetic perception and dentists' perception of the anterior tooth. However, the correlation between the total PES/WES and the VAS score for the first premolar was not statistically significant. Conclusions: The PES/WES is an objective tool in rating the esthetics of implant supported single crowns and adjacent soft tissues. Orthodontists were the most critical observers, while periodontists were more generous than other observers. The statistical analysis revealed a statistically significant correlation between patients' esthetic perception and dentists' perception of the anterior tooth.

• The Journal of Advanced Prosthodontics
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• v.1 no.3
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• pp.140-144
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• 2009

STATEMENT OF PROBLEM. Little information is available about the buccal gingival level of multiple implant restorations. PURPOSE. This study was aimed to evaluate the relationship between width and height of buccal soft tissue around single and 2 adjacent implant restorations. MATERIAL AND METHODS. Four implant restoration groups (first and second molars, single second molars, posterior single restorations between teeth, and anterior single restorations between teeth) were randomly chosen from one dental institute. Each group comprised of 6 patients. After 6 months of function, silicone impressions were taken and stone models were fabricated for each restoration group. The stone models were cut in bucco-lingual direction at the most apical point of buccal gingival margin. The height and width of buccal supra-implant soft tissue were measured. One way ANOVA and Tukey HSD post hoc tests were performed to analyze the data obtained (P < .05). RESULTS. The most unfavorable width-height ratio was noted for the group, which was comprised of the second molar in the multiple adjacent (first and second molar) implant-supported restorations. The group also resulted in the shorter height of buccal supra-implant mucosa rather than that of anterior single implant restorations between natural teeth. CONCLUSION. To achieve a favorable level of buccal gingival margin, greater thickness of buccal supra-implant mucosa is required for the implant restorations without a neighboring natural tooth compared to the implant restorations next to a natural tooth.

• Journal of Periodontal and Implant Science
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• v.32 no.1
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• pp.69-87
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• 2002

Implant material, implant design, surface quality, status of the bone, surgical technique, and implant loading conditions were regarded as prerequisites for osseointegration which is a prime condition for implant success. The aim of this review paper was to investigate the survival rate of single implants in relation to the prerequisites for osseointegration. Fifty-eight papers reporting survival rates of single implants were selected by use of the 'PubMed' and hand searching. The survival rate of single implants were assessed with reference to factors influencing osseointegration. The results showed that single implants in general showed a high survival rate except a few failures in certain extreme conditions and early stages. Those failures and complications such as screw loosening and esthetic problem were almost solved with the development of implant components and surgical techniques and a better understanding of biology around a single implant. Single-tooth implant-replacement is now considered as a reliable and predictable treatment option for a single missing tooth and its application seems to expand to compromised situations which were previously thought to be impossible for single implant therapy.

• The Journal of the Korean dental association
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• v.37 no.9 s.364
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• pp.636-640
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• 1999

• Journal of the Korean Academy of Esthetic Dentistry
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• v.16 no.2
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• pp.7-18
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• 2007

There is now an increased demand for harmony between the peri-implant gingiva and adjacent dentition. In the event of a pending loss of a single tooth in the aesthetic zone with healthy periodontium, expectation for optimal gingival and prosthodontic aesthetics are often very high. Unfortunately, bone resorption is common following the removal of an anterior tooth, compromising the gingival tissue levels for the eventual implant restoration. Also, improper implant placement and inadequate osseous-gingival support potentially deleterious aesthetic result. The creation of an esthetic implant restoration with gingival architecture that harmonizes with the adjacent dentitionis formidable challenge. The predictability of the peri-implant esthetic outcome may ultimately be determined by the patient's own presenting anatomy rather than the clinician's ability to manage state-of-the-art procedures. To more accurately predict the peri-implant esthetic outcome before removing a failing tooth, a considering of diagnostic keys is essential. This presentation addresses the useful diagnostic keys that affect the predictability of peri-implant gingival aesthetics and the overcoming of the risk factors in anterior single-tooth replacement; it also describes a surgical and prosthodontic technique in achieving a long term successful esthetic outcome. Proper diagnosis and understanding of the biological and periodontal variables of failing dentition and their response to surgical and prosthodontic procedures are the essence of predictability. Using a smart protocol that alters the periodontium toward less risk and more favorable assessment of the diagnostic keys before implant placement will provide the most predictable esthetic outcome. Simple diagnostic keys suggested this presentation are useful method to evaluate the overcoming of the risk factors in anterior single implant restoration.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.3
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• pp.233-243
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• 2012

The aim of this study was to evaluate time serial change of the TPTC(Tightness of Proximal Tooth Contact) between the implant prosthesis and natural tooth at rest state. Thirty-one patients(19 males and 12 females; mean age, 48.2 years) restored with a total 31 single-implant crowns in the left maxillary for 13 single-implant and left mandibular second molars for 18 single-implant crowns, respectively were selected. The TPTC was checked directly after delivery, 1 month after delivery and 6 months after delivery of prothesis at rest state. The TPTC decreased significantly as time goes by both maxilla(p<.01) and mandible(p<.05). The TPTC between the implant prosthesis and natural tooth decreased as time goes by after fixed implant prothesis placement.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.3
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• pp.238-245
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• 2008

STATEMENT OF PROBLEM: Interpoximal papilla could be re-established without immeidate support with a provisional resotration following an immdiate implant placement. PURPOSE: Successful esthetic outcomes were reported utilizing immediate provisionalization following immediate implant placements. The aim of this study was to evaluate the soft tissue esthetics around immediately placed single tooth implant restorations with or without immediate provisional restorations. METHODS: A total of ten patients, who had a hopeless maxillary anterior tooth, were enrolled in this study. Screw retained provisional restorations were delivered to the randomly chosen 5 patients (immediate provisionalization group) on the day of immediate implant placement and maintained for about 5 months. For the remaining five patients (non-immediate provisionalization group), healing abutments were delivered on the day of surgery, replaced with screw retained provisional restorations approximately 3 months afterwards, and the provisional restorations were maintained for about 3 months. Digital photographs were taken at the delivery of final restorations in order to assess following variables; mesial papilla, distal papilla, soft tissue level, soft tissue contour and facial soft tissue prominence. The variables were compared to those of the contralateral natural tooth and scored by prosthodontists, periodontists, orthodontists and dental students. RESULTS: The immediate provisionalization group marked significantly higher scores on the following variables; soft tissue level and facial soft tissue prominence. In evaluating each variable, there were no notable differences in opinion between four dentist groups. CONCLUSION: Immediate provisionalization can be a treatment option to achieve superior soft tissue esthetics around immediately placed single implant restorations rather than non-immediate provisionalization approaches.

• The Journal of the Korean dental association
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• v.39 no.9 s.388
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• pp.710-715
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• 2001