Objective To assess the clinical outcomes of flapless, immediate implant placement with simultaneous augmentation of dehiscence defects and immediate provisional restoration. Materials and Methods Retrospective evaluation of 40 periodontal patients who received a flapless immediate implant for single‐tooth replacement with simultaneous augmentation of dehiscence defects and immediate provisional restoration, at follow‐up periods ranging from 1 year minimum to 7 years maximum. Dehiscence defects were augmented using autogenous bone grafts and/or deproteinized bovine bone mineral, and autogenous or allogeneic connective tissue grafts. The following aspects were evaluated: clinical success (Clinical Oral Implants Research, 8, 1997, 161), crestal bone loss (calibrated digital periapical X‐rays) and aesthetics (Pink Esthetic Score, PES). Additionally, a questionnaire was devised to obtain patient's subjective evaluation. Results A 98.3% (95% CI: 91%–99%) success rate was observed. At 8 weeks, mean bone loss was 0.47 mm (n = 39); between 8 weeks and 1 year, this va lue attained 0.24 mm and between years 1 and 5 years 0.06 mm (n = 9). The evaluated PES in 37 single‐tooth implants was 12.4, with PES = 7 (aesthetic failures) in two cases, and aesthetic outcomes were excellent (PES ≥ 12) in 29 cases (78.4%). When compared with the contralateral tooth, a recession under 1 mm was observed in 78% of cases. The patient's subjective satisfaction value ranged from 98% to 100%. Conclusion This type of minimally invasive treatment of alveoli with buccal plate deficiencies delivers, in the hands of an experienced clinician, a high clinical and aesthetic success percentage being rated by patients as satisfactory. Clinicians should be aware that 1–2 mm comparative recession could be observed.

Regeneración periodontal en defectos intraóseos de 2-3 paredes con tres membranas diferentes. Un ensayo clínico randomizado Periodontal regeneration in two and three-wall intrabony defects by the use of three different barrier membranes. A randomized clinical study Resumen: Fundamento: El objetivo del presente artículo es valorar la eficacia clínica, medida en términos de ganancia de inserción clínica, de dos membranas reabsorbibles, frente a un control positivo, membrana no reabsorbible, en el tratamiento de defectos intraóseos de 2-3 paredes. Pacientes y método: Seleccionamos 36 pacientes en los que detectamos 43 lesiones intraóseas de 2-3 paredes. Previamente a la cirugía se registró la profundidad de sondaje y la recesión gingival (nivel de inserción clínica). Tras el abordaje con un colgajo de espesor total, el desbridamiento y medición de los defectos y la instrumentación de la pared radicular, se colocó la membrana. Se realizó un seguimiento clínico a las 1, 2, 4, 6, 8 semanas, 3, 6 y 12 meses, y radiográfico a los 6 y 12 meses. Resultados: Finalizaron el estudio 36 defectos, correspondientes a 30 pacientes. Al año hubo una reducción en la media de la profundidad de sondaje de 3,98 mm, un incremento de la recesión de 0,17 mm y la ganancia clínica de inserción (NCI) fue de 3,97 mm. No encontramos diferencias significativas entre las diferentes membranas utilizadas.Abstract: Background: A study is made to evaluate the clinical efficacy, in terms of clinical attachment gained, of two resorbable membranes versus a positive control (non-resorbable membrane), in the treatment of two-three wall intrabony defects. Patients and method: We selected 36 patients in whom 43 two-three wall intrabony lesions were detected. Prior to surgery we recorded pocket depth and gingival recession (clinical attachment level). After a full thickness flap approach, debridement and measurement of the defects, and instrumentation of the root wall, the membrane was placed. Clinical follow-up was carried out after 1, 2, 4, 6 and 8 weeks, and 3, 6 and 12 months, with radiological controls after 6 and 12 months.Results: A total of 36 defects completed the study, corresponding to 30 patients. After one year a mean reduction in pocket depth of 3.98 mm was recorded, with a 0.17 mm recession increment and a clinical attachment gain (NCI) of 3.97 mm. No significant differences were observed between the different membranes used.Enrile de Rojas FJ, Buitrago-Vera PJ, Sicilia-Felechosa A y Tejerina-Lobo JM. Regeneracion periodontal en defectos intraóseos de 2-3 paredes con tres membranas diferentes. Un ensayo clínico randomizado. RCOE 2006;11(1):23-37.BIBLID [1138-123X (2006)11:1; enero-febrero 1-140] Abreviaturas: IP = índice de placa; IG = índice gingival; IS = índice de sangrado; Prof. Sondaje = profundidad de sondaje.