A one-stage approach for nonsubmerged implants using a xenograft in narrow ridges: report on seven cases

In narrow alveolar ridges, dehiscences can occur at the time of implant placement. This report describes several cases in which buccal dehiscences at one-stage, nonsubmerged ITI implants were covered with deproteinized bovine bone mineral (Bio-Oss) and a nonresorbable e-PTFE membrane. The dehiscences ranged from 5 to 8.5 mm. The head of the implant perforated the membrane and was not covered by the mucoperiosteal flap. Membranes were removed after 12 to 20 weeks. One of the seven implants failed to osseointegrate. In four cases, no residual defect was found (100% coverage). In two cases, 63.5% and 87.5% coverage was obtained, respectively. At follow-up, 1 year and 5 months to 4 years and 7 months after placement and after loading, clinical probing depth never exceeded 3.5 mm. Radiographically, no resorption was found. In selected cases, dehiscences at the time of placement of nonsubmerged one-stage implants can be successfully treated using deproteinized bovine bone in combination with stiff, nonresorbable membranes.