OBJECTIVETo evaluate the clinical results of minimally invasive extraction without flap reflection and immediate implant placement with single-stage surgical procedure.

METHODSTwenty-one patients (23 single-tooth implants) were included in the study. Eight fractured teeth and 15 residual roots in the maxillary anterior region were extracted without flap reflection and implants placed immediately. Special gingival former was connected at the same time of implant placement with single-stage surgical procedure, final prostheses were restored after 6 months. The follow-up time was from 13 months to 51 months (mean: 27.6 months) after final restoration. Clinical and radiographic study were conducted, the interproximal papillae were analyzed according to Jemt's classification and the level of soft-tissue margin and buccal soft tissue color were evaluated according to Fürhauser's method.

RESULTSAll 23 implants acquired osseointegration, and the level of marginal bone at the mesial and distal aspects of all implants were stable. The mesial and distal papilla index score of 3 were observed in 18 implant sites, the papilla index score of 2 in 5 implant sites. Harmonious relationship of gingival margin between peri-implant restorations and adjacent natural teeth was observed in 15 implant sites. The color of buccal soft tissue matched that of the adjacent natural teeth in 18 implant sites, 5 sites showed minor discrepancies. All the patients were satisfied with the final restoration.

CONCLUSIONSMinimally invasive extraction without flap reflection and immediate implant placement with single-stage surgical procedure is a sensitive technique. Many factors may affect the final results and the strict control of indication is the key factor.