Impact of immediate restoration on bone remodeling in the esthetic zone: A randomized clinical trial

Authors

• Hao-Dong Wang, Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China; Laboratory of Dental Biomaterials and Tissue Regeneration, Shanghai Xuhui District Stomatological Hospital, Shanghai, China
• Xin-Hai Lin, Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
• Yi-Wen Wu, Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
• Hong-Run Zhou, Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
• Tai Zhao Wei, Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
• Xi Chen, Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
• Yi-Qun Tang, Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
• Ya-Qin Zhu, Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, ChinaFollow
• Long Jiang, Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, ChinaFollow

DOI

https://doi.org/10.1016/j.jds.2026.02.009

Abstract

Background/purpose

Traumatic loss of anterior teeth creates esthetic challenges and often requires immediate rehabilitation. Although immediate implant placement and restoration (IIPR) shortens treatment time, strict primary stability limits its use. A native-crown restoration supported by fiber-reinforced composite (FRC) splints may broaden the indications of immediate restoration, but its effectiveness remains unclear. This randomized controlled trial aimed to evaluate the effects of the novel immediate restoration following IIP on peri-implant bone remodeling in anterior esthetic zone trauma during osseointegration.

Materials and methods

Twenty participants undergoing IIP in the anterior maxilla were randomized into two groups. In the experimental group, immediate restorations were performed using patients’ native crowns stabilized with FRC splints, while the control group received conventional delayed restorations. Peri-implant bone remodeling was quantitatively assessed through cone-beam computed tomography (CBCT) at baseline and 4–5 months postoperatively. Secondary outcomes included gingival healing and implant stability quotient (ISQ).

Results

Both groups achieved 100 % implant survival. Complete soft tissue closure was clinically observed in all cases within 4–5 months postoperatively. No significant intergroup differences were found in peri-implant bone changes at the implant neck (P = 0.878) or 2 mm apically (P = 0.667). Similarly, mean ISQ values (Experimental: 75.6 ± 2.4; Control: 74.1 ± 3.4) showed no significant intergroup difference (P = 0.271).

Conclusion

The FRC-splinted immediate restoration protocol did not demonstrate additional adverse effects on early peri-implant bone remodeling or osseointegration within the observation period. It may offer an alternative option for immediate esthetic rehabilitation following IIP, particularly in cases where primary stability is limited.

Recommended Citation

Wang, Hao-Dong; Lin, Xin-Hai; Wu, Yi-Wen; Zhou, Hong-Run; Wei, Tai Zhao; Chen, Xi; Tang, Yi-Qun; Zhu, Ya-Qin; and Jiang, Long, "Impact of immediate restoration on bone remodeling in the esthetic zone: A randomized clinical trial" (2026). Articles in Press. 32.
https://jds.ads.org.tw/articles_in_press/32