Friday, August 04, 2017

Immediate implant placement into posterior sockets with or without buccal bone dehiscence defects: A retrospective cohort study



Abstract

Objectives

To evaluate bone reconstruction and soft tissue reactions at immediate implants placed into intact sockets and those with buccal bone dehiscence defects.

Methods

Fifty-nine internal connection implants from four different manufacturers were immediately placed in intact sockets(non-dehiscence group, n = 40), and in alveoli with buccal bone dehiscence defects: 1) Group 1(n =  N10), the defect depth measured 3–5 mm from the gingival margin. 2) Group 2(n = 9), the depth ranged from 5 mm to 7 mm. The surrounding bony voids were grafted with deproteinized bovine bone mineral (DBBM) particles. Cone beam computed tomography(CBCT) was performed immediately after surgery (T1), and at 6 months later(T2). Radiographs were taken at prosthesis placement and one year postloading(T3). Soft tissue parameters were measured at baseline (T0), prosthesis placement and T3.

Results

No implants were lost during the observation period. For the dehiscence groups, the buccal bone plates were radiographically reconstructed to comparable horizontal and vertical bone volumes compared with the non-dehiscence group. Marginal bone loss occurred between the time of final restoration and 1-year postloading was not statistically different(P = 0.732) between groups. Soft tissue parameters did not reveal inferior results for the dehiscence groups.

Conclusions

Within the limitations of this study, flapless implant placement into compromised sockets in combination with DBBM grafting may be a viable technique to reconstitute the defected buccal bone plates due to space maintenance and primary socket closure provided by healing abutments and bone grafts.

Clinical significance

Immediate implants and DBBM grafting without using membranes may be indicated for sockets with buccal bone defects.

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