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Aesthetic Outcome of Implant Supported Crowns With and Without Peri-implant conditioning using Provisional Fixed Restorations. A Three Year Randomised Controlled Clinical Trial.
EAO Online Library. DAVID F. Oct 9, 2018; 232675; P-PA - 3
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Achieving an optimal aesthetic result using dental implants is challenging. Fixed implant-supported provisional crowns are often used to customise the emergence profile and to individualise the surrounding peri-implant soft tissue.The aim of this study is to evaluate whether the use of a provisional implant supported crown leads to an aesthetic benefit on implants that are placed in the aesthetic zone, three years after loading.**The null hypothesis is that there is no difference between the two study groups.Twenty single implants were inserted in consecutive patients using an early implant protocol. After reopening, a randomisation process assigned them to either cohort group 1- a provisional phase with soft tissue conditioning using the dynamic compression technique or cohort 2- without a provisional. Implants were finally restored with an all ceramic crown. Follow up Examinations were preformed at 3, 12 and 36 months including implant aesthetic success and survival, clinical and radiographic parameters.After 3 years all implants were successfully integrated. One patient was excluded due to fracture of the adjacent tooth. Mean values of combined modPES and WES were 15.6 (SD 3,20) for group 1 and 12.2 (SD 3.86) for group 2. This was statistically significant and the null hypothesis could be rejected. **Mean bone loss after 3 years was -0.05 and -0.04 for groups 1 and 2 respectively, without being statistically significant.1. A provisional phase with soft tissue conditioning does improve the final aesthetic result. 2. The provisional phase does not increase bone loss.**The clinical implication is that in cases of high aesthetic demand the treatment protocol should include the use of a provisional implant supported restoration.
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