Buccal Bone Resorption in Immediate SLActive Implant Placement Thin vs. Thick Buccal Bone

With the increased demand for aesthetics and the expectation of immediate tooth replacement, improving the treatment options in case with hopeless teeth in the esthetic zone by immediate implants is a need by both practitioners and patients.

Current guidelines, today, restricting such treatment to only thick (+ or = 1mm) buccal bone plates. However, the literature shows that less than 10% of the community have such criteria, making it a high risk but needed procedure.

Soft tissue and bone remodelling after extraction is an inescapable fact. Immediate implant placement cannot prevent soft tissue and bone remodeling around implants (Araújo et al. 2005, Chen et al. 2009), but implant surface treatment and modifications might enhance the maintainability of the supporting structures around the dental implant due to its faster integration, better stimulating the vascular components at the site. This could be tested by the crestal and buccal bone changes, pink esthetic score and ostell readings.

Inclusion criteria

• Single bounded irrestorable tooth in the esthetic zone that needs to be extracted.
• Healthy systemic condition.
• Type I socket with a minimum of 1mm of buccal bone thickness prior to extraction. (Morton et al., 2014)
• Sufficient bone apical to the socket for implant primary stability. (Morton et al., 2014)
• Good oral hygiene.
• Patient accepts a minimum of three-year follow-up period (cooperative patients).

Exclusion criteria

• Signs of acute infection related to the area of interest.
• Patients with parafunctional habits (Lobbezoo et al. 2006 and Roelhing et al. 2016).
• Smokers (Lambert et al. 2000).
• Pregnant females.