Single-Tooth Immediate Placement and Provisionalization with Subcrestally Angulated Implants in Sites with Hard and Soft Tissue Facial Dehiscence in the Esthetic Zone: An Observational Study with 2 to 5 Years of Follow-up.

This study evaluated the survival and esthetic outcome of flapless postextraction placement and provisionalization in compromised single tooth sites in the esthetic area. Ten patients were included in the study, and 10 subcrestally angled (SCA) tapered implants were placed. Only maxillary central or lateral incisors and canines were included. Implants showed 100% survival rate, a limited mean marginal bone loss of 0.43 +/- 0.23 mm, and a mean gain in coronal gingival level of 1.6 +/- 1.17 mm; the mean vertical alveolar bone gain was 4.0 +/- 1.5 mm, and the average pink esthetic score was 12.5 at a mean 3.5-year follow-up (range: 2 to 5 years). These results show that immediate replacement and restoration of a tooth with compromised hard and soft tissue condition in the esthetic area, with simultaneous use of connective tissue, bone graft, and membrane, could be a valid alternative to a more complex staged approach.