To the top

Page Manager: Webmaster
Last update: 9/11/2012 3:13 PM

Tell a friend about this page
Print version

Natural or palatal positi… - University of Gothenburg, Sweden Till startsida
To content Read more about how we use cookies on

Natural or palatal positioning of immediate post-extractive implants in the aesthetic zone? Three-year results of a multicentre randomised controlled trial.

Journal article
Authors David Peñarrocha-Oltra
Miguel Peñarrocha-Diago
Raúl Fernández Encinas
Daniela Rita Ippolito
Erta Xhanari
Marco Esposito
Published in International journal of oral implantology (New Malden, London, England)
Volume 12
Issue 2
Pages 181-194
ISSN 2631-6439
Publication year 2019
Published at Institute of Clinical Sciences, Department of Biomaterials
Pages 181-194
Language en
Keywords Animals, Bone Transplantation, Cattle, Dental Implantation, Endosseous, Dental Implants, Single-Tooth, Esthetics, Esthetics, Dental, Humans, Immediate Dental Implant Loading, Spain
Subject categories Biomaterials Science


To evaluate whether there is a difference in aesthetic outcomes positioning immediate post-extractive implants in the natural position (where the tooth should have been in relation to adjacent teeth/implants) or approximately 3 mm more palatally.Just after tooth extraction, 20 patients requiring one single immediate maxillary post-extractive implant, from second premolar to second premolar, were randomly allocated to receive either an implant positioned in the natural 'central' position where the tooth should have been (central group; 10 patients) or approximately 3 mm more palatally (palatal group; 10 patients) according to a parallel-group design at two different centres. When needed, sites were reconstructed and bone-to-implant gaps were filled with granules of anorganic bovine bone, covered by resorbable collagen barriers. Implants were left submerged for 4 months and rehabilitated with provisional crowns, replaced after 4 months by metal-ceramic definitive crowns. Patients were followed to 3 years after loading. Outcome measures were: crown and implant failures, complications, aesthetics assessed using the pink aesthetic score (PES), peri-implant marginal bone level changes and patient satisfaction, recorded by blinded assessors.Three patients from each group dropped out up to 3 years after loading. One implant failed in each group (14%), the difference being not statistically significant (difference in proportion = 0.00; 95% CI: -0.39 to 0.39; P = 1.000). Two palatal group patients and one natural position patient had a complication each, the difference being not statistically significant (difference in proportion = 0.14; 95% CI: -0.28 to 0.52; P = 1.000). Three years after loading, the median PES was 12.5 (interquartile range [IQR] 5.0) for the central and 10.0 (IQR 10.0) for the palatal group, the difference being not statistically significant (median difference = -1.5; 95% CI: -10.0 to 5.0; P = 0.476). Three years after loading, patients of the central group lost 0.25 (IQR 0.40) mm of peri-implant marginal bone and those of the palatal group 0.20 (IQR 0.88) mm, the difference being not statistically significant (median difference = 0.15 mm; P [Mann-Whitney U test] = 0.486). Patients of both groups were equally satisfied at 3 years after loading for both function and aesthetics (both P = 0.699).These preliminary results suggest that positioning of immediate post-extractive implants 3 mm more palatally may not improve aesthetics; however, the sample size of the present study was very limited, thus larger trials are needed to confirm or reject the present findings. Conflict of interest statement: Mozo-Grau, Valladolid, Spain, the manufacturer of the implants used in this investigation, donated the implants and partially supported this trial; however, data belonged to the authors and by no means did the sponsor interfere with the conduct of the trial or the publication of its results.

Page Manager: Webmaster|Last update: 9/11/2012

The University of Gothenburg uses cookies to provide you with the best possible user experience. By continuing on this website, you approve of our use of cookies.  What are cookies?