Date on Master's Thesis/Doctoral Dissertation

12-2006

Document Type

Master's Thesis

Degree Name

M.S.

Department

Oral Biology

Committee Chair

Greenwell, Henry

Subject

Dental implants

Abstract

Aims. The primary aim of this study was to compare esthetic outcomes for the Nobel Replace Standard implant vs. the Nobel Perfect Scalloped implant as determined by hard and soft tissue measurements and objective and subjective esthetic indices. Methods. 18 patients with a tooth in the maxillary esthetic zone scheduled for replacement with an immediate implant who had at least one adjacent tooth were included in the study. Nine test patients received a Nobel Perfect scalloped platform implant and 9 positive control patients received a Nobel Replace 2-stage flat platform implant. Prior to suturing a fixture level impression was taken to allow provisional fabrication by a laboratory. Implant uncovering and provisionalization occurred at 2 months after fixture placement. Final impressions were taken at 4 months and the final crown was placed at 6 months. Results. Implants platforms were placed a mean of 2.5 to 3.0 mm apical to the facial gingival margin, a mean of about 1.5 mm coronal to the facial osseous margin, and a mean of about 2.0 mm from the adjacent tooth. There was a statistically significant mean loss of osseous height on adjacent teeth of about 1.5 mm (p < 0.05). with no significant differences between scalloped and standard groups (p > 0.05). The osseous crest to contact distance was a mean of about 5.5 to 6.0 mm at crown placement with no significant differences between groups (p > 0.05). There was minimal facial recession of about 0.3 mm at the time of crown placement and the gingival margin was harmonious with adjacent teeth 78% of the time for both scalloped and standard groups. A papilla completely filled the embrasure space in 11 of 17 sites for the scalloped group and in only 2 of 18 sites for the standard group. Thus there was papilla harmony with adjacent teeth 67% of the time for the scalloped group and only 33% of the time for the standard group. Subjective visual analog scores by the patient ranged from 98 to 99 for the scalloped group and from 93 to 94 for the standard group. Conclusions. Adjacent tooth interproximal bone loss and crest to contact distance were more than desirable but similar for both the scalloped and the standard groups. Despite this finding there was a substantially higher incidence of complete papilla formation and papilla harmony for the scalloped group. Subjective patient determined visual analog scores were consistently higher for the scalloped group. Thus there was a trend toward better esthetics with the scalloped implant at the time of crown placement.

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