Objective: To evaluate the changes in buccal bone dimensions (CBD) following immediate implant placement in the maxillary esthetic zone and to identify the factors influencing the degree of buccal bone resorption for different placement and restoration protocols.Material and methods: An electronic search was conducted using the EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and MEDLINE (PubMed) databases, combined with a manual and gray literature search, up to January 2021.Selected clinical studies had to report the changes in horizontal buccal bone dimension in maxillary immediate implantation sites (premolar to premolar) at baseline and at follow-up visits within a year of implantation. A meta-analysis was conducted to calculate the mean value of the changes in horizontal and vertical buccal bone dimensions (CHBD and CVBD) around implants. To further investigate the heterogeneity and identify factors associated with buccal bone loss after immediate implant placement, subgroup analysis and univariate meta-regression were performed.Results: From a total of 3498 articles, 4 randomized controlled trials and 12 nonrandomized controlled trials were included for analysis. The mean survival rate of 568 implants was 99.6%. The mean CHBD and CVBD values were 0.71 mm (95% confidence interval: [0.56, 0.86]) and 0.58 mm (95% confidence interval: [0.43, 0.72]), respectively. For possible factors that related to bone resorption, including buccal bone thickness, flap design, bone grafting, horizontal defect dimension, and restoration protocol, bone grafting was the only variable that significantly influenced CHBD.Conclusions: This study demonstrated that immediate implant placement in the esthetic zone does not prevent buccal bone from resorption. Due to data heterogeneity and the small sample size of the studies included in the analysis, further wellconducted, randomized controlled trials with homogeneous samples are required to investigate the correlation of CBD with different variables.

Objective: To investigate the release of bone morphogenetic protein-2 (BMP-2) and collagen type I proteins (COL1) from different sources ofdemineralized dentine matrix (DDM) and their chemotaxis to mouse osteoprogenitor cells.Methods: The release kinetic of BMP-2 and COL1 was measured from custom-made DDM (CMDDM) and commercially available DDM (CADDM).Using Urist physicochemical method, CMDDM was collected from the extracted teeth in a certified dental clinic. Levels of BMP-2 and COL1 releasedwere measured at days 1, 2, 3, 5, 7, 9, 11, and 13. Next, mouse osteoprogenitor cells, MC3T3-E1, were cultured with a variety of materials as follows:CMDDM, CADDM, Bio-Oss®, and blank control in transwell system. The number of cell migration was determined by crystal violet staining to explorechemotaxis of different DDMs to mouse osteoprogenitor cells.Results: BMP-2 was detected at 588.32 ± 14.53 pg/ml from 5 g of CMDDM. In the release kinetic assay, the concentration of BMP-2 in the CMDDMgroup increased rapidly and peaked at 113.9 pg/ml on day 5, almost four times higher than that of CADDM. The release of COL1 showed similarpattern in both CMDDM and CADDM; however, the amount was significantly higher in the CMDDM group. In cell culture experiment, the number ofmigrated MC3T3-E1 was ranked as the highest in CMDDM, followed by CADDM and Bio-Oss® (p<0.05).Conclusion: CMDDM released BMP-2 and COL1 greater than CADDM, which can induce more osteoblast-like cell migration. These results demonstrateda release kinetic of proteins and osteoinductivity of CMDDM, which supports a benefit of using autogenous bone graft.