Immediate Implant Placement in the Esthetic Zone with Marginal Preservation: Esthetic Outcomes in Sites with Thin Buccal Bone Wall

PurposeTo assess facial soft tissue levels and buccal bone thickness following immediate implant placement in compromised maxillary anterior sockets using marginal preservation technique.Materials and MethodsA total of 49 patients with failing maxillary anterior teeth were assigned to single immediate implant placement using appropriately sized implants, combined with absorbable collagen matrix membrane and sticky demineralized freeze-dried bone allograft grafting. Definitive crown placement occurred 6 months after provisionalization. The primary outcome was the change in soft tissue levels, assessed using pink esthetic score (PES). Additionally, survival rates and buccal bone thickness were evaluated.ResultsThe implant survival rate at 6-month follow-up was 100%. After 6 months, the overall PES significantly increased from 6.16 +/- 2.23 to 7.31 +/- 0.87 (p = 0.002). There was no statistically significant difference in esthetic outcomes between thick and thin gingival phenotypes. Implants with immediate provisionalization had a higher PES compared to those with delayed provisionalization (7.53 +/- 0.76 and 7.04 +/- 0.93, respectively, p = 0.041). A positive gain in buccal bone thickness was observed at 6-month post-surgery, and the timing of provisionalization (immediate versus delayed) did not significantly influence buccal bone thickness.ConclusionImmediate implant placement combined with a marginal preservation technique resulted in optimized esthetic outcome and positive changes in buccal bone thickness.