Implant Treatment After Traumatic Tooth Loss: A Retrospective Cohort Study of Survival, Esthetic, and Patient-Reported Outcome

OBJECTIVE: Evidence on biological, technical, and esthetic outcomes following dental implant treatment in the anterior maxilla after traumatic tooth loss is limited. Therefore, this study aimed to evaluate the survival, esthetic, and patient-reported outcome measures of implant treatment in the anterior maxilla after up to 9 years of functional loading.

MATERIAL AND METHODS: The study was conducted at Copenhagen University Hospital, Denmark. Patients who underwent implant treatment for anterior maxillary tooth loss due to trauma between 2007 and 2019, with at least 1 year of functional loading, were recalled for clinical and radiographic follow-up.

RESULTS: In total, 56 implants in 49 patients were included. The mean follow-up period was 4.2 years (range 1-9.5 years). Implant and superstructure survival rates were 100%. Between baseline and the latest follow-up, there was no statistically significant change in radiographic crestal bone level, but a statistically significant improvement in papilla index. Although not significant, soft tissue texture appeared to improve, while slight soft tissue discoloration was observed in most patients, but remained unchanged from baseline to follow-up. Crown esthetics generally declined from baseline to follow-up, although not significantly. Correlation analysis indicated an association between esthetic outcomes and several variables, such as age, gender, number of lost teeth, type of bone defect, and complications before loading. In total, 14% of implants exhibited crown infraposition at follow-up. No predictive factors for crown infraposition could be identified. Patient-reported outcome measures generally revealed satisfaction with the treatment results.

CONCLUSIONS: The present study found that the biological, technical, and esthetic outcomes of dental implant treatment in the anterior maxilla following traumatic tooth loss are, in general, stable and satisfactory to both clinician and patient. To achieve optimal results in these complex cases, interdisciplinary treatment planning is essential.