Immediate implant placement and provisionalization (IIPP) has been described as a treatment option with acceptable esthetic results for anterior single tooth loss. However, evidence shows marginal gingival recession as a common complication, specially in patients with a compromised facial bone wall at the time of extraction. Twenty patients with a central or lateral maxillary incisor indicated for extraction and IIPP were selected. Implants (BL SLA®ctive, Straumann) were placed by the same surgeon in sockets with intact (control) and compromised (test) facial walls. Autogenous bone harvested from the tuberosity was grafted in both groups. After 1 year, all implants were osseointegrated. At T3, PES was 9,9 ± 2,5 (control) and 10,2 ± 2,0 (test). IIPP presented good esthetic results in both groups when evaluated by dentists and by patients. During the first year, the PES evolved positivelly in the test group. The volume reduction of the alveolar process didn`t interfere in the esthetic results.
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