BackgroundIt is unclear whether an intact buccal bony plate is a prerequisite for immediate implant placement in postextraction sockets. The aim of this 10‐year randomized controlled trial was to compare peri‐implant soft and hard tissue parameters, esthetic ratings of, and patient‐reported satisfaction with immediate implant placement in postextraction sockets with buccal bony defects ≥5 mm in the esthetic zone versus delayed implant placement after alveolar ridge preservation.MethodsPatients presenting a failing tooth in the esthetic region and a buccal bony defect ≥5 mm after an extraction were randomly assigned to immediate (Immediate Group, n = 20) or delayed (Delayed Group, n = 20) implant placement. The second‐stage surgery and provisional restoration placement occurred 3 months after implant placement in both groups, followed by definitive restorations 3 months thereafter. During a 10‐year follow‐up period, marginal bone levels (primary outcome), buccal bone thickness, soft tissue parameters, esthetics, and patient‐reported satisfaction were recorded.ResultsThe mean marginal bone level change was −0.71 ± 0.59 mm and −0.36 ± 0.39 mm in the Immediate Group and the Delayed Group after 10 years (p = 0.063), respectively. The secondary outcomes were not significantly different between both groups.ConclusionsMarginal bone level changes, buccal bone thickness, clinical outcomes, esthetics, and patients’ satisfaction following immediate implant placement, in combination with bone augmentation in postextraction sockets with buccal bony defects ≥5 mm, were not statistically different to those following delayed implant placement after ridge preservation in the esthetic zone.Plain language summaryImmediate implant placement in case of a failing tooth is a favorable treatment option for patients because it considerably shortens treatment time and the number of surgical treatments. The question is if an intact buccal bone wall is necessary for immediate implant placement. A 10‐year study was performed in which 20 patients with a failing tooth in the frontal region of the upper jaw were treated with immediate implant placement and were compared with 20 patients in whom a more conventional treatment strategy was followed in which the failing tooth was first removed and the bone gap restored and the implant placed in a second step. After a 10‐year follow‐up period, it appeared that the bone around the implant was very stable, gums were healthy, and patients were very satisfied with the result. There was no difference between the two treatment procedures. Such results mean that professionals can discuss the procedure with the patient and apply the individual's preference.

中文翻译：

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在骨缺损部位立即植入单牙种植体：一项为期 10 年的随机对照试验


背景尚不清楚完整的颊骨板是否是在拔牙后牙槽窝中立即植入种植体的先决条件。这项为期 10 年的随机对照试验的目的是比较美学区颊骨缺损≥5 mm 的拔牙后牙槽窝中立即种植体的种植体周围软组织和硬组织参数、美学评级以及患者报告的满意度。保留牙槽嵴后延迟种植体植入。 方法 拔牙后美学区域出现牙齿缺失且颊骨缺损≥5 mm 的患者被随机分配到即刻组（即刻组、 n = 20）或延迟（延迟组， n = 20) 种植体植入。两组患者均在种植体植入后 3 个月进行第二阶段手术和临时修复体植入，随后 3 个月进行最终修复体。在 10 年随访期间，记录边缘骨水平（​​主要结果）、颊骨厚度、软组织参数、美观和患者报告的满意度。结果平均边缘骨水平变化为 -0.71 ± 0.59 mm 和 - 10年后立即组和延迟组为0.36±0.39毫米（ p = 0.063），分别。两组之间的次要结果没有显着差异。结论立即种植体植入后的边缘骨水平变化、颊骨厚度、临床结果、美观和患者满意度，结合颊侧骨缺损≥5 mm的拔牙后牙槽窝骨增量，与美学区牙槽嵴保留后延迟种植体植入后的结果没有统计学差异。通俗易懂的总结在牙齿失效的情况下立即种植牙对于患者来说是一种有利的治疗选择，因为它大大缩短了治疗时间和手术治疗的次数。问题是，立即植入种植体是否需要完整的颊骨壁。进行了一项为期 10 年的研究，其中 20 名上颌额区牙齿缺失的患者接受了即刻种植体植入治疗，并与 20 名接受更传统治疗策略（即对缺失牙齿进行修复）的患者进行了比较。首先将其移除，然后恢复骨间隙，然后在第二步中放置植入物。经过10年的随访，种植体周围的骨骼非常稳定，牙龈健康，患者对结果非常满意。两种治疗程序之间没有差异。这样的结果意味着专业人员可以与患者讨论手术并应用个人的偏好。