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Marco Degidi Giuseppe Daprile Diego Nardi Adriano Piattelli

Buccal bone plate in immediately placed and restored implant with Bio-Oss® collagen graft: a 1-year follow-up study

Authors’ affiliations: Marco Degidi, Giuseppe Daprile, Diego Nardi, Private Practice, Bologna, Italy Adriano Piattelli, Department of Oral Pathology, Dental School, University of Chieti, Chieti, Italy Correspondingauthor: Prof Adriano Piattelli, Via F. Sciucchi 63 66100 Chieti, Italy Tel.: +39 0871 3554083 Fax: +39 0871 3554076 e-mail:

Key words: biomaterial, extraction socket, immediate loading, immediate placement, ridge

Abstract Objectives: The aim of this study was to radiographically assess the vertical and horizontal alterations of buccal alveolar bone after theinsertion of a post-extractive implant using Bio-Oss® Collagen graft. Material and methods: The study was designed as a prospective study. Adult patients were eligible for the study if they needed one or more immediately inserted and immediately restored implant replacing teeth to be extracted within region 15–25. After the insertion, the buccal gap was carefully grafted using Bio-Oss® Collagen and theimplant immediately restored. Cone-Beam Computed Tomography (CBCT) was performed immediately after surgery and a series of measurements were made to determine the dimension of the buccal bone plate and the void between implant and extraction socket. A second CBCT was taken and the measurements repeated after 12 months. Results: Altogether, 69 patients were included in the study; a total of 69implants were inserted. The study demonstrated that the extraction of a tooth and the immediate insertion of an implant together with an xenograft resulted in alterations of the vertical and horizontal dimension of the buccal bone plate (respectively, 25.6% and 29.3%). Nevertheless, the vertical and horizontal gap reduction was nearly complete (respectively, 99.3% and 99.1%) and the implant wasnormally in contact with buccal bone. Conclusions: Implant placement into extraction sockets can result in favorable radiological results even in the presence of evident alterations of the buccal bone wall.

Date: Accepted 29 June 2012
To cite this article: Degidi M, Daprile G, Nardi D, Piattelli A. Buccal bone plate in immediately placed and restored implant with Bio-Oss® collagen graft: a 1-yearfollow-up study. Clin. Oral Impl. Res. 00, 2012, 1–5 doi: 10.1111/j.1600-0501.2012.02561.x

The immediate placement of implants after tooth extraction is a common clinical practice with a success rate similar to implants placed in healed sites (Covani et al. 2004; Evian et al. 2004) Nevertheless, recent histological studies on dogs conducted by Araujo et al. (2005, 2006) showed a resorption ofthe bone around immediately placed implants: the authors report that the buccal as well as the lingual bone walls were resorbed; at the buccal aspect, this resulted in some marginal loss of osseointegration. Similar results were published by another study on dogs by Botticelli et al. (2006), which concluded that care must be exercised when implants are placed in fresh extraction sockets. A recentsystematic literature review ( Quirynen et al. 2007) proposed the same recommendations and concluded that the resorption of the buccal bone plate in the first month after tooth extraction

should be considered when selecting patients for immediate/early implant placement. Furthermore, Sanz et al. (2010) concluded in a prospective randomized-controlled clinical trial that implant placement intoextraction sockets will result in significant bone reduction in alveolar ridge with a mean vertical bone loss of 1 mm in the buccal aspect. Conversely, several studies report very good clinical results (Botticelli et al. 2004; Covani et al. 2007; Cosyn et al. 2011) and also a human histological study (Paolantonio et al. 2001) carried on 48 immediate implants, demonstrated that, after 12 months, 95%...