Changes in soft tissues around immediate full arch rehabilitations: a prospective study

INTRODUCTION: Nowadays, aesthetic appearance is receiving more and more attention from clinicians and patients. Therefore, it is of paramount importance for the surgeon to maintain or to improve the quality and the stability of the soft tissue-implant interface. The scientific literature supports the idea that the immediate placement and provisionalization of endosseus implants and abutments can indeed offer additional clinical control over the peri-implant tissue architecture. On this basis, this prospective study aims to evaluate the changes in soft tissues around immediately loaded dental implants in full-arch rehabilitations, over a period of 3 months. MATERIALS AND METHODS: Fifteen subjects were treated for immediate full-arch rehabilitations. Following implant placement, provisional rehabilitations made of bisphenol-A-glycidyldimethacrylate (BIS-GMA) and resin were placed. All records were made using a periodontal probe. The facial soft-tissue level was measured evaluating the distance between the soft-tissue margin and the incisal edge of the crown. Moreover, papilla levels were measured at the mesial and distal sites from a reference line connecting the occlusal edge of the crowns. RESULTS: The average value at the mesial site was -0.035 mm (±1, median 0 mm), while at the midfacial site, it was 0 mm (±0.76, median 0 mm) and at the distal site, -0.05 mm (±0.92, median 0 mm). The plaque score index showed a reduction during the follow-up period. DISCUSSION: Our data indicate that no differences at the midfacial point were detectable over the observation period. This is in agreement with several studies; it is plausible that these results are linked to a correct position of the implant in the alveolar socket. Moreover, comparing our results with what has been reported by other authors, it is surprising that while other studies highlight that papilla loss at the mesial and distal aspect is an expected consequence of immediate implant restorations, our data do not show any changes. The explanation of these results remains unclear. Further studies are needed to support our data and to clarify what mechanisms are involved in the maintenance of soft tissue