Factors influencing long-term outcomes of immediate implantation in the aesthetic zone and clinical decision strategies
10.12016/j.issn.2096-1456.202550229
- Author:
LI Yi
1
,
2
,
3
,
4
,
5
;
LU Cheng
1
,
2
,
3
,
4
,
5
;
QIU Lixin
1
,
2
,
3
,
4
,
5
Author Information
1. Fourth Clinical Division, Peking University School and Hospital of Stomatology &
2. National Center of Stomatology &
3. National Clinical Research Center for Oral Diseases &
4. National Engineering Laboratory for Digital and Material Technology of Stomatology &
5. Beijing Key Laboratory of Digital Stomatology
- Publication Type:Journal Article
- Keywords:
dental implants;
esthetic zone;
immediate implant;
immediate loading;
minimal invasive therapy;
periodontal phenotype;
bone augmentation;
digital-aided technique;
long-term effects
- From:
Journal of Prevention and Treatment for Stomatological Diseases
2025;33(9):719-731
- CountryChina
- Language:Chinese
-
Abstract:
Immediate implant placement in the aesthetic zone has become increasingly widespread and has gradually evolved into a conventional techniques for implant procedures in the aesthetic region. To achieve favorable aesthetic and long-term outcomes, clinicians must possess extensive clinical experience as well as proficient surgical and restorative skills. This study summarizes the key factors influencing the long-term success of immediate implants in the aesthetic zone: strict adherence to the indications for immediate implant placement; thorough preoperative assessment of the patient’s systemic and local conditions, along with comprehensive evaluation of aesthetic risks; minimally invasive tooth extraction while preserving the integrity of the labial bone plate; selection of appropriately designed implants and their placement in an ideal three-dimensional position based on the implant’s characteristics; utilization of suitable bone and soft tissue augmentation techniques according to the patient’s specific hard and soft tissue anatomy, extent of bone defects, and periodontal phenotype; dynamic shaping of soft tissues through continuous adjustments in the emergence profile of provisional restorations; design of definitive restorations from the perspectives of health, function, and aesthetics; and implementation of regular follow-up and maintenance protocols after implant treatment, with increased emphasis on peri-implant care for patients who smoke, have diabetes, or undergo anti-osteoporosis therapy. This study proposes a decision-making framework to achieve long-term stable clinical outcomes with immediate implants in the aesthetic zone, providing a reference for clinicians in their clinical decision-making and treatment planning: ① for patients assessed as low aesthetic risk (e.g., thick gingival biotype, absence of hard and soft tissue defects, intact labial bone plate with thickness >1 mm, no acute infection), immediate implant placement after minimally invasive extraction is recommended, with the implant positioned in an ideal three-dimensional location, along with bone grafting in the gap between the implant and the labial bone plate and consideration of connective tissue grafting when required; ② for patients assessed as moderate aesthetic risk (e.g., thin gingival biotype, absence of soft tissue defects, intact labial bone plate but with thickness <1 mm or mild to moderate bone defects involving less than 50% height loss, chronic infection present), immediate implant placement with optimal three-dimensional positioning is feasible, accompanied by bone grafting in the implant-labial bone gap or external bone grafting on the labial aspect, with simultaneous or staged connective tissue grafting, or alternatively, use of the socket shield technique for immediate implant placement; ③ for patients assessed as high aesthetic risk (e.g., thin gingival biotype, presence of soft tissue defects, vertical bone deficiency, severe labial bone loss involving >50% height loss, acute infection present), ridge preservation followed by delayed implant placement is advised. By adhering to these treatment principles, immediate implant placement in the aesthetic zone can achieve reliable success rates and excellent aesthetic outcomes.
- Full text:2025090511045211344美学区即刻种植长期效果的影响因素及临床决策.pdf
