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Volume 34 , Issue 6
November/December 2019

Pages 15051511

Customized vs Conventional Implant-Supported Immediate Provisional Crowns for Fresh-Socket Implant: A Medium-Term Cone Beam Computed Tomography Study

Giovanni-Battista Menchini-Fabris, DDS/Ugo Covani, MD, DDS/Giovanni Crespi, MD/Paolo Toti, BSc, DDS/Bruno Brevi, MD/Roberto Crespi, MD, MSc

PMID: 31711090
DOI: 10.11607/jomi.7199

Purpose: To measure the volume effect on maintaining a sealing around immediately rehabilitated dental implants in a comparison between customized and conventional provisional crowns at a 3-year follow-up. Materials and Methods: A single crown supported by a dental implant was used as a rehabilitation strategy for a failing tooth. The primary predictor was the type of immediate restoration with custom or conventional provisional crowns; a secondary predictor was tooth position: incisor, canine, or premolar. In order to accurately measure the width between buccal and palatal plates at the alveolar margin in a comparison between preoperative (before tooth extraction) and postoperative (at the 3-year follow-up) radiographs, two cone beam computed tomography (CBCT) scans were three-dimensionally analyzed and superimposed. Results: Seventy-six patients, rehabilitated with single implants, were selected (31 implants belonging to the custom group and 45 to the conventional group). In patients treated with conventional restorations, a significant shrinkage (0.6 1.2 mm with P = .002) was registered. On the other hand, the bone change registered for the custom restoration group appeared negligible, with a nonsignificant and slight increase in width (+0.2 0.7 mm). When the subgroups regarding the implant sites were investigated, the decrease in width was very limited for the canine tooth in the custom group (0.3 0.2 mm), whereas the shrinkage at the canine in the standard group appeared to be significantly higher (1.5 0.7 mm with P = .0001). Conclusion: An anatomically contoured provisional restoration may provide a strategy to stimulate peri-implant soft tissue healing, minimize loss of buccal bone plate at the marginal level, and maintain pristine volume in the alveolar bone better than noncustomized restorations.

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