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Abstract :
[en] Objectives: Repeted abutment connection and disconnections compromize the connective and epithelial sealing around implant components, leading to peri-implant bone remodeling (Abrahamsson, 1997). Placing the definitive abutment at the time of implant placement might be a treatment option to minimize this biological rupture. The aim of this study was to evaluate the effectiveness of pre-shaped zirconium abutments for immediate implant loading in the anterior maxilla.
Materials and methods: A total of 13 patients needing the placement of one or several implant in the esthetic zone were treated with Regular Crossfit Bone Level (Straumann) implants. Implants were placed and immediately restored with a pre-shaped zirconium abutments and provisional resin crowns if the primary stability reached at least 20 N/cm2. Implant survival rate, biological and prosthodontic complications as well as peri-implant tissue status (papilla index) were recorded during a follow-up period of 1 year.
Results: A total of 14 implants (8 incisors, 1 canines, 5 premolars) placed in 11 patients (4 men / 7 women) aged from 22 to 60 years old (48,5 +/- 11,5) could be assessed for the entire follow-up period. 2 patients dropped out. All implants reached an adequate primary stability (> 20N/cm2) to perform an immediate implant restoration. Straight pre-shaped Zirconium abutment was used in each case. Six implants were placed in socket preservation sites and five implants were placed simultaneously with a GBR. After a follow-up period of 1 year, all implants fulfilled survival criteria for dental implants with regard to osteointegration, including the absence of peri-implant radiolucency, implant mobility, suppuration, and pain. One abutment screw loosening was observed during the provisional period and no abutment fracture occurred. Definitive full ceramic-cemented restorations were successfully performed on each implant after a mean period of 6 months and no further complications occurred. In 11 out of 14 implants, an improvement of the papilla index was observed from baseline to 1 year follow-up whereas 3 implants showed a decrease of this index.
Conclusion: The results from this prospective case series suggest that immediately restored implants using a final pre-shaped zirconium abutment in esthetic zone display favorable implant and prosthodontic outcomes and seems to allow an adequate papilla index improvement in most of the cases.