Soft Tissue Dilemma in Immediate Implant Placement

Introduction:

The idea of immediate implant placement was created to decrease the time period between extractions and implant placement. Whenever an immediate implant wanted to be positioned in ideal 3D position, the gap should always be grafted with biomaterial. From the common complications associated with immediate implant placement are the gingival recession and deficiencies of the per-implant soft tissues. Prevention of these complications is far way preferred than trying to fix them after they occur. This is why soft tissue augmentation is recommended to be done simultaneously with implant placement.

Aim:

The aim of the present study is to evaluate clinically and radiographically the changes of the soft and hard tissues that occur with immediate single implant in the aesthetic zone using bone substitute with and without subepithelial connective tissue graft.

Patients and Methods:

– Group A (Study Group): Extraction and placement of 8 immediate implants were carried out. The horizontal gap distance between the immediately placed implant and the socket bony wall was filled with anorganic bovine bone (ABB) and a free subepithelial connective tissue graft (CTG) harvested from the palate was inserted in the labial mucosa. 

– Group B (Control Group) Extraction and placement of 8 immediate implants were carried out. The horizontal gap distance between the immediately placed implant and the socket bony was filled with an- organic bovine bone (ABB).

-Clinical, radiographic and volumetric analysis were conducted to evaluate bone and soft tissue changes.

Results:

  • Study group showed statistically significantly higher mean mucosal thicknesses than control group.
  • Pre- as well as post-operatively; there was no statistically significant difference between median thickness of labial plate of bone in the two groups.
  • Study group showed statistically significantly higher median volumetric change than control group.

Conclusion:

  • Soft tissue augmentation is mandatory incases of thin gingiva biotype with immediate implant placement to avoid later esthetic complications in high esthetic concern areas.
  • Volumetric assessment is a promising accurate assessment method to detect dimensional changes.
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