[Changes of soft tissue profile of maxillary edentulous patients with immediate denture].

Purpose: To compare the changes of soft tissue profile of maxillary edentulous patients before and immediately after implant restoration, as well as to investigate patient satisfaction with postoperative facial appearance.

Methods: A total of 24 patients treated in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January 2018 to December 2020 were selected, the medical history and positive lateral cephalometric film of the patients before and after restoration were collected. Preoperative facial scanning of the patients was performed using the portable 3D facial scanner to design the immediate transitional denture restoration and then perform implant surgery. The collected lateral cephalograms of patients before and after treatment were imported into the computer. The angle measurement items before and after implant immediate denture restoration were analyzed including nasolabial angle, prn'-sn'-ul'(Ls), n'-prn'-sn', N-prn-Pog, Z angle, H angle and line measurements including the distance of upper lip to the E-plane and Sn-Prn. The soft tissue angle and lines were measured by Dolphin Imaging 11.95. Postoperative patient satisfaction with facial appearance was surveyed via telephone questionnaire. SPSS 26.0 software package was used for data analysis.

Results: Before restoration of immediate denture, the nasolabial angle and the distance of upper lip to the E-plane of both male and female patients was significantly different from the standard value, and the Z angle of female patients was significantly different from the standard value. After immediate denture restoration, there was no significant difference in nasolabial angle and the distance of upper lip to the E-plane between male and female patients, but there was significant difference in H angle, and nasal tip angle in female patients. After immediate denture restoration, there was no significant difference between the nasolabial angle, H angle and the distance of upper lip to the E-plane in male and female patients after immediate denture restoration, while the soft tissue convexity and Z angle between male and female patients after immediate denture restoration were significantly different compared with the standard value of the attractive individuals. After completion of immediate denture restoration, compared to the edentulous state in maxillary implant treatment, significant changes were observed in nasolabial angle, Z angle, and H angle in patients. The survey of seven questions had a mean score above 3 points (scoring standard 1-5, with 5 being the highest), indicating high patient satisfaction with the appearance after immediate denture restoration.

Conclusions: After immediate denture restoration, the profile of the patient's soft tissue can be improved immediately, and the patient's soft tissue profile can basically return to the normal level, and even meet the standards of beautiful people. It is necessary to guide clinicians to further optimize the function and shape of prostheses in combination with patients' subjective aesthetic demands and individual conditions when conducting implant immediate transition denture restoration.