Evaluation of hard tissue replacement composite graft material as a ridge preservation/augmentation material in conjunction with immediate hydroxyapatite-coated dental implants.
BACKGROUND
Immediate placement of dental implants (DI) in fresh extraction sockets is associated with remaining voids around the DI and often a partial dehiscence or thin facial alveolar plate. Bone replacement grafts are often used to correct these problems. This study evaluated the use of a layered composite of PMMA (poly-methyl-methacrylate), PHEMA (poly-hydroxyl-ethyl-methacrylate), and calcium hydroxide grafts (HTR) as a ridge preservation/ augmentation material used in conjunction with an immediate DI placement technique.


METHODS
Twenty-three patients requiring 1 or 2 extractions that were treatment planned for immediate DI placement received 4.0 or 3.25 mm diameter hydroxyapatite-coated cylindrical implants in the extraction sockets. HTR was used to fill the remaining socket void and enhance the facial ridge width. A collagen hemostatic was placed to cover the DI sites, flaps released, and primary closure attempted with sutures. DI uncovering was performed at about 6 months. Measurements were taken to the nearest 0.5 mm of the internal socket width and total ridge width at DI placement and uncovering.


RESULTS
Thirty DIs were placed in the 23 patients. Mean initial internal socket width was 6.9 mm. The total ridge width showed a mean change from 9.1 mm to 8.4 mm; 60% of the areas showed a net increase or no change, while 40% showed a decrease in overall ridge width. DI success rate was 97% out to 6 months of loading.


CONCLUSIONS
The results of this study suggest that HTR is a useful adjunct in the placement of immediate DIs for filling of socket voids and preservation of ridge width.
Yukna
Raymond A
RA
Department of Periodontics, Louisiana State University, School of Dentistry, New Orleans, LA 70119, USA. ryukna@lsuhsc.edu
Castellon
Paulino
P
Saenz-Nasr
Ana M
AM
Owens
Kris
K
Simmons
Jason
J
Thunthy
Kavas H
KH
Mayer
Elizabeth T
ET
D000293:Adolescent; D000328:Adult; D000368:Aged; D000540:Alveolar Ridge Augmentation; D001672:Biocompatible Materials / Q000737:chemistry; D018786:Bone Substitutes / Q000627:therapeutic use*; D002126:Calcium Hydroxide / Q000627:therapeutic use; D020099:Coated Materials, Biocompatible / Q000737:chemistry; D003188:Composite Resins / Q000627:therapeutic use*; D000044:Dental Abutments; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D017886:Durapatite / Q000737:chemistry; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D008768:Methylmethacrylates / Q000627:therapeutic use*; D008875:Middle Aged; D011102:Polyhydroxyethyl Methacrylate / Q000627:therapeutic use*; D018709:Statistics, Nonparametric; D020390:Tooth Socket / Q000601:surgery; D016896:Treatment Outcome
D001672:Biocompatible Materials; D018786:Bone Substitutes; D020099:Coated Materials, Biocompatible; D003188:Composite Resins; D015921:Dental Implants; D008768:Methylmethacrylates; D011102:Polyhydroxyethyl Methacrylate; C040206:HTR composite; D017886:Durapatite; D002126:Calcium Hydroxide