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Randomized Controlled Trial
. 2025 Feb;27(1):e70013.
doi: 10.1111/cid.70013.

A Randomized Controlled Trial on the Timing of Soft Tissue Augmentation in Immediate Implant Placement: Soft Tissue Changes and Esthetic Outcome

Thibault Struys  1 , Véronique Christiaens  1 , Thomas De Bruyckere  1 , Jeremy Pitman  1 , Pieter-Jan Van Hove  1 , Jan Cosyn  1
Affiliations
Randomized Controlled Trial

A Randomized Controlled Trial on the Timing of Soft Tissue Augmentation in Immediate Implant Placement: Soft Tissue Changes and Esthetic Outcome

Thibault Struys et al. Clin Implant Dent Relat Res. 2025 Feb.

Abstract

Aim: To assess the impact of the timing of soft tissue augmentation on soft tissue changes and esthetic outcome following single immediate implant placement (IIP) in the anterior maxilla.

Materials and methods: Patients with a failing tooth and intact buccal bone wall in the anterior maxilla (15-25) were enrolled in this RCT. Following single IIP and socket grafting, they were randomly allocated to the control group (immediate soft tissue augmentation performed in the same surgical procedure-ISTA) or the test group (delayed soft tissue augmentation performed 3 months later-DSTA). Implants were placed with a surgical guide and immediately restored with an implant-supported provisional crown. Changes in soft tissue dimensions were assessed by a blinded clinician using superimposed STL files taken prior to surgery and at 1-year follow-up. The esthetic outcome was rated by a blinded clinician and the patient at 1-year follow-up. The study adhered to the STA-COSM (Soft Tissue Augmentation-Core Outcome Set and Measurements for implant dentistry trials) guidelines.

Results: Twenty patients were randomized to each group (control: 16 females, 4 males, mean age 57.6; test: 9 females, 11 males, mean age 54.2). The mean change in buccal soft tissue profile was -0.251 and 0.083 mm for ISTA and DSTA, respectively. The mean difference of -0.318 mm in favor of DSTA was not significant (95% CI: -0.860 to 0.224, p = 0.241). Median midfacial recession was -0.200 and - 0.350 mm for ISTA and DSTA, respectively. The median difference of 0.200 mm in favor of ISTA was not significant (95% CI: -0.210 to 0.700, p = 0.311). Mesial and distal papillary recession, Pink Esthetic Score and patients' esthetic satisfaction failed to demonstrate a significant difference between the groups.

Conclusion: In patients with an intact buccal bone wall, the timing of soft tissue augmentation following IIP had no significant impact on soft tissue changes and esthetic outcome.

Trial registration: ClinicalTrials.gov: NCT05537545.

Keywords: connective tissue graft; dental implant; immediate; single tooth.

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References

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