Background After a single tooth extraction, remodelling processes are initiated and morphological changes occur in the alveolar bone. It has been suggested that implant placement in a fresh extraction socket may partly reduce the alveolar ridge contraction and that several factors like the thickness of the buccal bone wall and the size of the gap between the implant and the facial bone wall may play a role on peri‐implant tissues dimensional alterations. Methods Twenty‐six patients treated with single‐tooth maxillary implants were included in this study. A CBCT exam allowed to access the initial buccal bone thickness (BT). Digital impressions were taken prior to extractions (T0), 1 month (T1), 4 months (T2), and 12 months (T3) after implant insertion and superimposed with a computer software allowing to quantitatively analyse the three‐dimensional changes occurred in the adjacent tissues. Variables related to thickness and volume were computed. Results Participants with BT ≤ 1 mm exhibited a significantly increased buccal peri‐implant tissue thickness change than patients with BT > 1 mm (P = 0.049). At T3 patients representing BT ≤ 1 mm exhibited a total volume change of −8.53% ± 5.47% compared with patients presenting BT > 1 mm, −4.37% ± 2.08%. No statistical significance was found on the distance between implant shoulder and the buccal bone plate (BID) effect. Conclusion After the first year of treatment peri‐implant tissues showed continuous changes resulting in a higher thickness and volume reduction at thin buccal bone plates.

Background: Immediate implant placement (IIP) associated with the use of bone substitutes and collagen matrices (CM) seems to reduce the amount of resorption at peri-implant areas. Recently, customized healing abutments (CA) appeared as another solution in order to seal the socket and preserve the original soft tissue contour.Purpose: To evaluate peri-implant tissues dimensional changes after using customized healing abutments compared with the use of xenogeneic collagen matrices as socket sealing options in flapless maxillary immediate implant placement. Material and methods:The present study was designed as a prospective, randomized, controlled clinical trial. Patients were allocated into two groups depending on the socket sealing option: in the CM group a collagen matrix was used and in the CA group a customized abutment. Digital impressions were taken prior to extraction, 1, 4, and 12 months after implant insertion and the digital files allowed to evaluate linear buccal changes (MBC) and the buccal volumetric variation (BVv) between the different time points at peri-implant tissue areas. Additionally, mucosa variation was computed assessing the papilla presence and the midfacial mucosa height. Statistical significance was set at 0.05.Results: Twenty-eight patients were observed during a 12-month period. Significant differences between mean values of BVv at the first month were observed at the CM and CA group (À9.75 ± 6.65% and À4.76 ± 5.29%, respectively) (p = 0.043). At the 1-year follow-up, no significant differences were found in terms of BVv between the two groups, although the thin bone phenotype (≤1 mm) significantly influenced the volumetric variations that occurred in each group. No significant differences were noticed in midfacial mucosa and papillae alteration between groups, after 1 year of treatment. Conclusion:Both treatment options are predictable solutions for socket sealing in IIP, although a higher volumetric variation can be expected in the presence of thin bone phenotypes.

ObjectivesTo evaluate buccal volume change after using a customized healing abutment with or without connective tissue grafts (CTG) in flapless maxillary immediate implant placement (IIP).Materials and MethodsThe present study was designed as a randomized clinical trial (RCT). Patients treated with flapless maxillary IIP were allocated into two groups, both receiving a customized healing abutment, and additionally, the test group received a CTG. A cone‐beam computerized tomography (CBCT) allowed to access the initial buccal bone thickness (BT). Digital impressions were taken prior to extractions (T0), 1 month (T1), 4 months (T2), and 12 months (T3) after implant insertion and superimposed with computer software allowing to compute variables related to buccal volume variation (BVv) and total volume variation (TVv) (ClinicalTrials.gov: NCT05060055).ResultsThirty‐two patients (mean age 48 ± 11 years), sixteen in each group, were evaluated after a 12‐month period. After 1 year of treatment, no significant differences were found between groups, although in participants with BT ≤1 mm, control and test groups showed a BVv of −14.18 ± 3.49% and −8.30 ± 3.78%, respectively (p = .033). Regarding mucosa height variation variables, the control group showed approximately the triple vertical recession in both papillae.ConclusionsThe placement of a CTG was not capable of completely maintaining the initial peri‐implant tissue architecture, although in thin‐bone phenotypes, less dimensional changes are expected when a CTG was used.