Alveolar ridge preservation and early implant placement at maxillary central incisor sites: A prospective case series study

Abstract

Purpose To assess whether alveolar ridge preservation (ARP) with 90% deproteinized bovine bone mineral in a 10% collagen matrix (DBBMC) and resorbable type I/III porcine collagen matrix (CM) maintains sufficient bone volume for early implant placement 8–10 weeks after extraction of maxillary central incisors. Materials and Methods In this case series study of 10 consecutively enrolled patients, sockets of maxillary single central incisors requiring extraction and early implant placement were grafted with DBBMC/CM. Ridge dimensions were measured pre‐extraction and just prior to implant placement. Results Alveolar ridge preservation maintained sufficient bone volume for implants to be placed in all sites. Compared to pre‐extraction, there was a significant reduction in the orofacial dimensions of the ridge (1.4 ± 1.07 mm; 13.2% reduction) and bone (0.7 ± 0.67 mm; 9.3%) at the coronal midfacial region. A significant reduction in apicocoronal height of the crestal bone at midfacial (1.2 ± 0.78 mm) and palatal aspects was observed. On CBCT, a statistically significant reduction in alveolar ridge area occurred (10.9 ± 13.42 mm2; 12.2% reduction). To optimize aesthetic outcomes, 9/10 sites required additional low volume grafting at the coronal region, whereas one site required more extensive grafting due to a facial bone dehiscence. At 1‐year, the implant survival rate was 100% and median Pink Esthetic Score (PES) was 10 (range 9–13). Conclusions ARP using DBBMC/CM maintains sufficient bone volume for early implant placement 8.9 ± 0.97 weeks later, with a 100% survival rate 1 year after restoration.

Early implant placement with or without alveolar ridge preservation in single tooth gaps renders similar esthetic, clinical and patient‐reported outcome measures: One‐year results of a randomized clinical trial

“…scores. In contrast, a recent case series applying early implant placement in 10 patients after ARP revealed a median PES score of 10 at one-year follow-up (Chen & Darby, 2020). Moreover, outcomes from a prospective study also revealed higher PES scores (Arora & Ivanovski, 2018).…”

“…Those lower PES scores compared with the present findings are most likely explained by the lack of papillary tissues observed in that study resulting in decreased PES scores. In contrast, a recent case series applying early implant placement in 10 patients after ARP revealed a median PES score of 10 at one‐year follow‐up (Chen & Darby, 2020 ). Moreover, outcomes from a prospective study also revealed higher PES scores (Arora & Ivanovski, 2018 ).…”

“…The higher PES scores observed in these two studies as compared with the present values could be attributed to methodological differences in the PES evaluation. The present study applied the modified PES evaluation using a scale from 0 to 10 (Belser et al, 2009) whereas the other two studies (Arora & Ivanovski, 2018;Chen & Darby, 2020) applied the original PES evaluation score using a scale from 0 to 14, thereby increasing the PES scores (Furhauser et al, 2005).…”

“…ARP procedures traditionally involve a healing period of 4–6 months (Avila‐Ortiz et al., 2019 ), and a shorter healing period may be insufficient for proper graft consolidation (Nelson & Mealey, 2020 ; Whetman & Mealey, 2016 ), thus weakening the added benefit of ARP. Notwithstanding, there has been an emerging clinical and research interest to reduce the healing period following ARP (Chen & Darby, 2020 ; Jonker et al., 2020 ; Lim et al., 2020 ; Thoma et al, 2020 ).…”

Evaluation of the clinical efficacy and safety of modified alveolar cleft bone graft with cone-beam CT digital imaging in children

“…Alveolar fissure bone grafting can fill and repair the gap of alveolar fissures, with the purpose being to rebuild the defect of the alveolar fissure so as to facilitate the emergence of cusp teeth ( 11 ). According to the time of bone grafting, alveolar ridge bone grafting can be divided into early stage (before 2 years old), early stage (2–5 years old), second stage (6–15 years old), and late stage (after 16 years old) ( 12 ). In this study, 8 patients were late stage II, and the remaining 12 patients were stage II, including 15 patients with tooth malformation extraction and loss of development in the bone graft area.…”