1. Immediate implant placement #15 alone-control group
Topic: Implant insertion after tooth extraction: clinical outcomes with different approaches
(including socket preservation, immediate, early and delayed placement)                                                
Immediate dental implant placement with and without the use of
bone grafting. A pilot study.
Zempila M., Doufexi A.E., Batas L., Konstantinidis A.
Dept. of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, Greece.
P2M620
Background and Aim
Material and Methods
The immediate placement of dental implants after tooth extraction is a common clinical practice with a success rate similar to implants placed in healed sites. Nevertheless, recent histological studies showed a resorption of the bone around immediately placed implants. This resorption was more pronounced at the buccal bone wall, which led to some marginal loss of osseointegration. On the other hand, several recent studies demonstrated that the use of bone graft materials placed in the extraction sites can counteract the marginal ridge contraction that normally occurs after tooth extraction. The aim of this study is to radiographically assess by the means of Cone-Beam Computed Tomography (CBCT), the horizontal alterations of buccal alveolar bone, after the insertion of immediate dental implants, with and without the use of xenograft as a bone filler.
8 patients requiring a single immediate post-extraction dental implant in the maxilla from second to second premolar, were randomly allocated to immediate implant placement alone (control group; 4 patients) or to immediately implant placement with the use of anorganic bovine bone in the buccal void (experimental group; 4 patients). In both groups no flap elevation was conducted and the implants were covered with healing abutments. A CBCT was performed immediately after surgery and a series of measurements were made to determine the dimensions of the buccal bone wall. A second CBCT was taken and the measurements repeated after six months.
Immediate implant placement #15 alone-control group A B C
2.5
Initial buccal bone width: 2.5mm .
1.7 D E F
Buccal bone width after 6 months: 1.7mm
Immediate implant placement #12 with bone graft-experimental group A B C
3.0
Initial buccal bone width: 3.0mm
Buccal bone width after 6 months: 2.8mm
2.8 D E F
Conclusions and Clinical Implications
Results
Immediate dental implant placement under certain circumstances, could provide the clinician with a reliable alternative with respect to delay implant placement. The use of bone graft in the buccal void, can eliminate the buccal bone resorption. More RCTs are necessary to draw certain conclusions.
After six months of healing, implants in both groups were successfully osseointegrated. Soft-tissue healing was uneventful with no signs of inflammation in both groups. As far as the CBCT measurements are concerned, there was a reduction in the six month measurement in relation to the buccal bone width in both groups. What is worth to mention though, is the fact that the mean reduction in the control group was almost 3 times larger than the experimental group.
References
Ferrus J., Cecchinato D., et al. Factors influencing ridge alterations following immediate implant placement into extraction sockets. Clin Oral Impl Res 2010; 21:
Araujo M.G., and Lindhe J. Dimensional ridge alterations following tooth extraction. An experimental study in the dog. J Clin Periodontol 2005; 32:
Araujo M.G., Sukekava F., et al. Ridge alterations following implant placement in fresh extraction sockets: an experimental study in the dog. J Clin Periodontol 2005; 32:
Araujo M.G., Linder E., and Lindhe J. Bio-oss Collagen in the buccal gap at immediate implants: a 6-month study in the dog. Clin Oral Impl Res 2011; 22: 1-8.
Presented at the 25nd Annual Scientific Meeting of the European Association of Osseointegration
2016, PARIS, France