Placement of an immediate implant is becoming popular because of its potential in minimizing the treatment time and enhancing the patient comfort and esthetic outcomes. It is crucial to maintain adequate thickness of labial bone with the establishment of a stable and healthy gingival seal around the implant abutment to prevent the invasion of bacteria and peri-implant inflammation. Diode lasers have been developed as a promising tool in dentistry, providing a precise manipulation and photocoagulation effect that may have a positive influence on both bone remodeling and soft tissue healing. This study aims to evaluate the effectiveness of the utilization of diode laser photocoagulation with immediate implant placement and customized healing abutment in the maxillary esthetic zone.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
8
patients with non-restorable teeth in the maxillary esthetic zone will be included in this prospective single-arm study. The non-restorable tooth will be atraumatically extracted and immediate implant placement will be placed. The extraction socket will be sealed with diode laser photocoagulation and customized healing abutments fabrication.
Faculty of Dentistry clinics, Beirut Arab University
Beirut, Lebanon
Change in pain socres
Pain will be evaluated, using visual analogue scale (VAS) as follows: (0-1= None, 2-4= Mild, 5-7= Moderate, 8-10= Severe)
Time frame: at 7, 14, and 21 days
Change in wound healing
The wound healing will be assessed based on Landry Wound Healing Index. The Landry Index uses a numerical score based on the assessment of four given parameters (Erythema, Edema, Wound Margin Adaptation, and Presence of Exudate). Each parameter is given a score depending on its severity, and the total score determine an overall evaluation of wound healing
Time frame: at 7, 14, and 21 days
Change in implant stability
The base line primary Implant Stability Quotient (ISQ) will be measured during the operative stage, while the secondary stability quotient will be measured 6-months post-operative during the prosthetic phase preparation.
Time frame: baseline and 6 months
Change in Crestal Alveolar Process width
The width of the crestal alveolar process will be assessed by determination of the dimensional changes of Bucco-palatal ridge in the 6 months' scan
Time frame: baseline and 6 months
Change in labial bone thickness
The overall persistence of the labial plate of bone after the atraumatic extraction and immediate implant placement will be evaluated by the assessment of the thickness labial plate of bone in the scan performed after 6 months and comparing it with the preoperative CBCT record. The distance will be measured from the root surface to the outer buccal bone surface in the preoperative CBCT record. Measurements will be performed on the cross-sectional cut of the CBCT at three levels; crestal labial thickness, middle labial thickness, and apical labial thickness.
Time frame: baseline and 6 months
Change in esthetic of soft tissue
The pink esthetic score (PES) introduced by Furhauser et al will be used for evaluation of the esthetic outcome of soft tissue surrounding single crowns supported by implant in the esthetic zone. The PES consists of seven factors each one is given a score of 2, 1, or 0, and a total score will be ranging between 0 and 14
Time frame: at 1 month
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