Immediate implant placement with immediate or delayed provisionalization in the maxillary aesthetic zone: A 10‐year randomized trial

Aim To compare the marginal bone level of immediately placed implants, with either immediate or delayed provisionalization (IP or DP), in the maxillary aesthetic zone after 10 years of function. Materials and Methods Participants with a failing tooth in the maxillary aesthetic zone were randomly assigned to immediate implant placement with either IP (n = 20) or DP (n = 20) after primary wound closure with a free gingival graft. The final restoration was placed 3 months after provisionalization. The primary outcome was change in marginal bone level. In addition, implant survival, restoration survival and success, peri‐implant tissue health, mucosa levels, aesthetic indices, buccal bone thickness and patient satisfaction were evaluated. Results After 10 years, the mean mesial and distal changes in marginal bone level were −0.47 ± 0.45 mm and −0.49 ± 0.52 mm in the IP group and −0.58 ± 0.76 mm and −0.41 ± 0.72 mm in the DP group (p = .61; p = .71). The survival rate was 100% for the implants; for the restorations, it was 88.9% in the IP group and 87.5% in the DP group. Restoration success, according to modified USPHS criteria, was 77.8% in the IP group and 75.0% in the DP group. The prevalence of peri‐implant mucositis was 38.9% and 35.7% and of peri‐implantitis 0.0% and 6.3%, respectively, in the IP group and DP group (p = 1.0; p = .40). The Pink Esthetic Score and White Esthetic Score was 15.28 ± 2.32 in the IP group and 14.64 ± 2.74 in the DP group, both clinically acceptable (p = .48). The buccal bone thickness was lower in the DP group. Patient satisfaction was similar in both groups (p = .75). Conclusions The mean marginal bone level changes after immediate implant placement with IP were similar to those after immediate placement with DP. Clinical Trial Registration Registered in the National Trial Register (NL9340).