Single-tooth replacement by immediate implant and connective tissue graft: a 1-9-year clinical evaluation

Objectives: The aim of the present study was to evaluate the long-lasting efficacy of a combined surgical protocol, using immediate implant and subepithelial connective tissue graft for single-tooth replacement. The advantages of this single-center, longitudinal, randomized, blind examiner research were the following: preservation of both keratinized mucosa amount and bone tissue, optimal peri-implant marginal sealing, satisfactory aesthetic results, reduction in treatment time. Materials and methods: In the time period from 1990 to 1998, 116 patients were consecutively admitted for treatment with a total of 116 solid screw ITI-implants supporting single crowns. Ninety-six patients underwent the proposed combined treatment (test group), while 20 received only single immediate implants (control group). The observation time extended from 1 up to 9 years. Results: The 9-year cumulative survival rate was 100% for both test and control groups. Comparative statistical analysis of soft and hard tissue peri-implant parameters demonstrated better results in the test group than in the control during every single 3-year analysis and especially in the last observation interval. The test group also showed very good results in terms of aesthetic parameters, which estimated the keratinized mucosa width, the alignment of crown emergence profile and the patient's satisfaction. Conclusion: Single-tooth replacement by immediate solid screw ITI implants in association with connective tissue autograft was demonstrated to be a predictable procedure. Moreover, this treatment can be considered as a sure system to reach an excellent functional and harmonious aesthetic restoration.