Vertical Crestal Bone Changes Around Implants Placed Into Fresh Extraction Sockets

Hospital of Versilia, Viareggio, Tuscany, Italy
Journal of Periodontology (Impact Factor: 2.71). 06/2007; 78(5):810-5. DOI: 10.1902/jop.2007.060254
Source: PubMed


The aim of this study was to analyze bone healing and vertical bone remodeling for implants placed immediately after tooth removal without guided bone regeneration techniques.
Twenty patients received 20 implants immediately after the removal of 20 teeth. All implants were placed within the undamaged alveoli confines, and the cervical portion of each implant was positioned at coronal bone level. The distance from implant shoulder and bone crest was measured for each implant at four sites (mesial, buccal, distal, and palatal/lingual). No membranes or filling materials were used. Primary flap closure was performed in all clinical cases.
All peri-implant bone defects had healed completely 6 months after implant placement. The pattern of bone healing around the neck of the implants showed an absence of peri-implant defects. The vertical distance between the implant shoulder and bone crest ranged from 0 to 2 mm.
The bone remodeling of implants placed in fresh extraction sockets showed a healing pattern with new bone apposition around the implant's neck and horizontal and vertical bone reabsorption. The vertical bone reabsorption, which has been observed at buccal sites, was not associated with any negative esthetic implications.

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    • "Teeth with zero wall defects were excluded from the study. Ugo covani in 2007 observed a significant amount of vertical bone absorption without the use of membranes and filling materials.[8] Use of Expanded polytetrafluoroethylene (ePTFF) membrane lead to complications like exposure and infection of the membrane and also stated that the barrier might disrupt the blood supply of the overlying soft tissue. "
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    ABSTRACT: The aim of the study was to evaluate the osseo-integration and soft tissue status of the endosseous implants placed in immediate extraction socket. Seven patients (4 males and 3 females) aged 20-30 years were selected for the study. Nine implants were placed in seven patients in the maxillary arch. All the patients were clinically αnd thoroughly examined. Under local anesthesia, the indicated tooth was extracted. The extracted socket was prepared using standard drills with palatal wall as guide. The longest and widest implants were placed (Hi-Tec Implants). All implants showed good primary stability. The implants used in the study were tapered design endosseous implants with Threaded implants (TI) unit plasma-sprayed surface. Surgical re-entry (secondary surgery) was performed to remove the healing cap after 6 months for supra crestal fabrication. All patients were reviewed periodically at 3(rd) and 6(th) month interval and the following clinical parameters including modified plaque index (mPlI), modified bleeding index (mBI), probing depth (PD), attachment level (AL), and distance between the implant shoulder and mucosal margin (DIM), distance between the implant shoulder and first bone-implant contact, and Clinical Mobility Index were recorded. The results were computed and subjected to statistical evaluation. The mPlI, mBI, PD, AL, and DIM were evaluated around the implants at baseline, 3(rd) and 6(th) month intervals and analyzed statistically by Friedman T-test. The results of the above were shown to be statistically non-significant. The distance between the implant shoulder and first bone implant contact was evaluated around the implants at base line, 3(rd) and 6(th) month intervals. The results proved to be statistically significant (0.01) implying that there was a bone apposition around the implants. During the course of the study, soft tissue status around implants was found to be healthy. Osseointegration as assessed by clinical and radiographic findings was found to be sound.
    No preview · Article · Mar 2014
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    • "Therefore, an immediate implant placement did not guarantee better results. However, according to this study and previous reports, immediate implant placement after extraction and guided bone regeneration are recommended for stability and aesthetics because the labial cortical bone of the anterior maxilla is particularly thin and more esthetically exposed than the mandible.17,19,24-26 "
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    ABSTRACT: The cortical bone thickness on the anterior region is important for achieving implant stability. The purpose of this study was to examine the thickness of the cortical and cancellous bones on the anterior region of the maxilla and mandible. Twenty-five cadaver heads were used (16 male and 9 female; mean death age, 56.7 years). After the long axis of alveolar process was set up, it was measured in 5 levels starting from 2 mm below the cementoenamel junction (L1) at intervals of 3 mm. All data was analysed statistically by one-way ANOVA at the .05 significance level. The cortical bone thickness according to measurement levels in both the labial and lingual sides increased from L1 to L5, and the lingual side below L3 was significantly thicker than the labial side on the maxilla and mandible. In particular, the labial cortical bone thickness in the maxilla was the thinnest compared to the other regions. The cancellous bone thickness according to measurement levels increased from L1 to L5 on the maxilla, and on the mandible it was the thinnest at the middle level of the root. For implant placement on the anterior region, a careful evaluation and full knowledge on the thickness of the cortical and cancellous bone are necessary, therefore, these results may provide an anatomic guideline to clinicians.
    Full-text · Article · Aug 2012 · The journal of advanced prosthodontics
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    • "Some research on immediate implant placement has indicated that bone remodeling, apposition, and healing of bony tissue take place also in the implant neck area. This is believed to be the reason for the lack of implications which negatively affect the final esthetics [60], and conclusions from a 1-year clinical study whereby 35 immediate implants were placed have also confirmed that the immediate implant placement protocol can result in satisfactory peri-implant soft tissue and esthetic outcomes [61]. "
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    ABSTRACT: Implant therapy has become a reliable and predictable treatment alternative for the replacement of missing teeth with conventional removable and fixed partial dentures. Recently though, in the pursuit for improved esthetics, the literature has dedicated a considerable amount of its research on the successful maintenance and regeneration of the surrounding gingiva and bone, which are lost following extraction of a tooth. Thoroughly analyzing the anatomic situation and well-planned treatment has become a requirement, because incorrectly planned and positioned implants may jeopardize long-term esthetic and functional prognosis. In addition, many types of biocompatible materials, autogenous hard and soft tissue grafts, and different surgical techniques have been developed, and their viability has been investigated. As a result, implant specialists have gained a greater understanding of the dynamics and anatomical and biological concepts of the periodontium and peri-implant tissues both at the surgical and prosthetic phases of treatment, which contributes to better soft and hard tissue management (SHTM). This may further contribute to achieving a superior final result which is obtained by having a harmonious soft tissue profile, a correctly placed and contoured final restoration, and the reestablishment of masticatory function and phonetics.
    Full-text · Article · Jul 2012 · International Journal of Biomaterials
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