Ridge Width Alteration After Implant Placement Into the Fresh Extraction Socket With Deproteinized Bovine Bone...

Immediate implant placement into a fresh extraction socket in an esthetic zone can be challenging because a reduction in ridge width after healing will result in gingival asymmetry.

In this case series, 17 consecutively treated patients with 19 immediately placed implants between maxillary second bicuspids were included. Only sites with an intact facial plate were included. If dehiscence or fenestration was found on the facial plate during extraction, the site was excluded. The implant was placed toward the palatal side, allowing a ≥2 mm gap between the implant body and the facial plate. This gap was grafted with deproteinized bovine bone mineral (DBBM). Sharp dissection and grafting using acellular dermal matrix (ADM) were performed on the facial side. A custom-made healing abutment was connected to the implant and allowed to heal for 3 months. Preoperative and 3-month postoperative models were used to measure the alteration in the ridge width at 2 and 5 mm from the preoperative gingival margin at the midfacial point. All implants healed without complications and integrated appropriately. Measurement comparison showed a 0.1 mm reduction and a 0.5 mm increase in the ridge width at the 2- and 5-mm positions, respectively. Biotype did not make difference in the outcome.

This case series demonstrates that, when DBBM and ADM were used during immediate implant placement into an intact extraction socket, minimal to no alteration in the ridge width was observed after 3 months of healing.