Alveolar ridge changes 1‐year after early implant placement, with or without alveolar ridge preservation at single‐implant sites in the aesthetic region: A secondary analysis of radiographic and profilometric outcomes from a randomized controlled trial

Abstract

ObjectivesTo assess both the radiographic and profilometric outcomes of early implant placement with or without alveolar ridge preservation (ARP) (using two different ARP techniques) after 1 year of loading.Materials and MethodsSeventy‐five patients with a failing single tooth in the anterior maxilla were randomly allocated to three groups (1:1:1): (a) ARP using demineralized bovine bone mineral containing 10% collagen (DBBM‐C) covered by a collagen matrix (CM), (b) ARP using DBBM‐C covered with a palatal graft (PG), and (c) unassisted socket healing (control). Eight weeks after tooth extraction, early implant placement was performed in all patients. Cone‐beam computed tomography (CBCT) and impressions were taken 8 weeks after tooth extraction (ARP/unassisted healing) prior to implant placement and 1‐year post‐loading. Radiographic and profilometric outcomes were evaluated.ResultsOut of the 70 patients available for re‐examination at 1‐year post‐loading, 55 datasets could be assessed (ARP‐CM 19; ARP‐PG 17; Control 19). The need for additional guided bone regeneration (GBR) at implant placement amounted to 31.6% (ARP‐CM), 29.4% (ARP‐PG), and 68.4% (unassisted healing). Adjusted models revealed that residual buccal bone height and additional GBR at implant placement significantly influenced the magnitude of the alveolar changes at 1 year (p < 0.05). In patients with ARP (group ARP‐CM or ARP‐PG) without additional GBR, the presence of bone convexity amounted to 36.0% (9/25) at 1‐year post‐loading. For patients that received ARP and additional GBR at implant placement, the frequency of bone convexity increased to 72.7% (8/11) (p = 0.042). Regarding profilometric measurements, a tendency toward agreement with radiographic outcomes was observed.ConclusionsEarly implant placement with ARP can attenuate alveolar ridge changes at 1‐year post loading by minimizing both radiographic and profilometric alterations. However, early implant placement with simultaneous GBR consistently yields superior radiographic and profilometric outcomes, regardless of whether ARP is performed.