Flapless Immediate Implant Placement and Provisionalization (FIIPP) in the Aesthetic Region: Surgical Protocol of a Prospective Clinical Cohort Study on 100 Patients – Two Case Reports: Intact Socket, and Defect Socket with a Thin Gingival Phenotype

A B S T R A C T

Background: Immediate implant placement and provisionalization (IIPP) is considered as a high-risk treatment for aesthetic failure and generally only recommended in case of post-extraction intact sockets and a thick phenotype gingiva. During a prospective clinical cohort study on one-hundred consecutive patients, using this strict flapless immediate implant placement and provisionalization (FIIPP) protocol, we found high and stable aesthetic outcomes (WES/PES = 8.2/12.1) in both intact – and defect sockets, and both thin- as thick gingival phenotype. By means of one case report (Case 1), the total FIIPP treatment is illustrated. Results of two other cases, show that comparable high aesthetic outcomes can be reached in cases with a thin phenotype gingiva or buccal bone defect using the same protocol.
Case Presentation: In a 24-year-old male with good general and oral health, root fracture of tooth 21 was diagnosed and FIIPP was indicated. Direct post-extraction, an implant was placed in a palatal position of an intact socket by a flapless approach. A minimum space of 2 mm in front of the implant was created and filled with a bone-substitute prior to implant placement. Subsequently, the implant was restored by use of a titanium abutment and a composite temporary crown. Three months later, the temporary crown was replaced by a customized zirconium abutment and ceramic crown resulting in a high aesthetic outcome. A comparable aesthetic outcome using this protocol can be reached in cases with a thin phenotype gingiva and/or a buccal bone defect (Case 2).
Conclusion: Using described surgical FIIPP protocol, high aesthetic outcomes are reached in only 4 visits and within a treatment period of 4 months. A thin phenotype gingiva, or a pre-operative buccal bone defect, does not seem to affect the aesthetic outcome using this treatment method.

Keywords

Immediate implant placement and provisionalization (IIPP), prospective clinical cohort study, flapless immediate implant placement and provisionalization (FIIPP), aesthetic outcome



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Article Info

Article Type
Case Report
Publication history
Received: Mon 03, May 2021
Accepted: Mon 17, May 2021
Published: Thu 27, May 2021
Copyright
© 2021 Edith Groenendijk. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository. All rights reserved.
DOI: 10.31487/j.SCR.2021.05.08

Author Info

Corresponding Author
Edith Groenendijk
Clinic for Oral Implantology and Restorative Dentistry, Implantologie Den Haag, The Hague, The Netherlands

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References

1.     Chen ST, Buser D (2014) Esthetic outcomes following immediate and early implant placement in the anterior maxilla--a systematic review. Int J Oral Maxillofac Implants 29: 186-215. [Crossref]

2.     Groenendijk E, Staas TA, Graauwmans FEJ, Bronkhorst E, Verhamme L et al. (2017) Immediate implant placement: the fate of the buccal crest. A retrospective cone beam computed tomography study. Int J Oral Maxillofac Surg 46: 1600-1606. [Crossref]

3.     Groenendijk E, Staas TA, Bronkhorst E, Raghoebar GM, Meijer GJ (2020) Immediate implant placement and provisionalization: Aesthetic outcome 1 year after implant placement. A prospective clinical multicenter study. Clin Implant Dent Relat Res 22: 193-200. [Crossref]

4.     Belser UC, Grütter L, Vailati F, Bornstein MM, Weber HP et al. (2009) Outcome evaluation of early placed maxillary anterior single-tooth implants using objective esthetic criteria: a cross-sectional, retrospective study in 45 patients with a 2- to 4-year follow-up using pink and white esthetic scores. J Periodontol 80: 140-151. [Crossref]

5.     Fürhauser R, Florescu D, Benesch T, Haas R, Mailath G et al. (2005) Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score. Clin Oral Implants Res 16: 639-644. [Crossref]

6.     Kan JYK, Roe P, Rungcharassaeng K, Patel RD, Waki T et al. (2011) Classification of sagittal root position in relation to the anterior maxillary osseous housing for immediate implant placement: a cone beam computed tomography study. Int J Oral Maxillofac Implants 26: 873-876. [Crossref]

7.     Rompen E, Domken O, Degedi M, Pontes AEF, Piatelli A (2006) The effect of material characteristics, of surface topography and of implant components and connections on soft tissue integration: a literature review. Clin Oral Implants Res 17: 55-67. [Crossref]