J Dent Res Dent Clin Dent Prospects. 2023;17(3): 170-176.
doi: 10.34172/joddd.2023.40593
  Abstract View: 351
  PDF Download: 317

Original Article

Long-term evaluation of combined prosthetic-surgical approach and soft tissue augmentation in the esthetic zone

David Nazarian 1 ORCID logo, Viktoriia Olegovna Dzhuganova 1* ORCID logo, Anastasia Nefedkina 2 ORCID logo, Georgy Zakharov 1 ORCID logo, Aleksander Fedosov 1 ORCID logo, Grigoriy Kyalov 1 ORCID logo, Arbak Khachatryan 1 ORCID logo

1 Maxillofacial and Reconstructive Surgery Department, Federal State Budgetary Institution The National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia, Moscow, Russia
2 IM Sechenov First Moscow State Medical University, Moscow, Russia
*Corresponding Author: Viktoriia Olegovna Dzhuganova, Email: viktorijadzhuganova@gmail.com


Background. There is no standard protocol for immediate implant placement and subsequent loading in the smile zone. We aimed to evaluate the long-term outcomes of simultaneous implant placement, soft tissue grafting, and immediate prosthetic loading in the esthetic zone.

Methods. Thirty-five implants were placed in the maxillary aesthetic zone. Twenty-two patients were evaluated using the Pink Esthetic Score (PES) and White Esthetic Score (WES). Also, the degree of peri-implant bone resorption and patient survey were applied for the esthetic and functional outcomes.

Results. The esthetic and harmonizing outcomes were achieved according to the mean total PES/WES value (17.9±2.0). The mean overall PES was 8.5±1.66. The papilla level had the highest mean score (1.8±0.36). Furthermore, the combination of root convexity/color and soft tissue color and texture was one of the key values in evaluating the effectiveness of this method (the mean value was 1.5±0.5). The mesial and distal papillae were 1.6±0.5 and 1.8±0.4, respectively. None of the 35 implants reached below 6 points (which is considered an esthetically unsatisfactory result). The mean WES score was 9.5±0.57. The average degree of total peri-implant bone resorption was 1.05±0.3 mm after 12 months. According to the questionnaire, all the patients smiled without hesitation and were satisfied with the treatment (100%).

Conclusion. This study showed that restoring one or more teeth in the smile zone using the concept of one-stage implant placement, soft tissue flap augmentation, and loading with provisional crowns was an esthetically successful and predictable method.

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Submitted: 15 Aug 2023
Revision: 25 Aug 2023
Accepted: 01 Oct 2023
ePublished: 11 Nov 2023
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