title: Soft tissue healing around implants placed immediately after tooth extraction without incision: a clinical report.
abstract: OBJECTIVE
  The purposes of the present study were to evaluate implants placed immediately after tooth extraction without incision or primary flap closure and to observe the peri-implant soft tissue healing.
  
  
  METHODS
  Fifteen patients (9 men and 6 women) aged 31 to 54 years were included in this study. Each patient had a tooth that required extraction, and each had at least 4 mm of bone beyond the root apex. Teeth with multiple roots were excluded from this study. After tooth extraction, the implants were immediately placed without incision or flap elevation. Implant sites showing bone fenestrations, bone dehiscences, or peri-implant bone defects exceeding 2 mm were excluded from this study. In these cases, a standard guided bone regeneration procedure with a surgical flap elevation was used. The second-stage surgical procedure was performed 6 months after the first procedure. The following clinical parameters were evaluated at the time of implant placement and at second-stage surgery: levels of mesial and distal papillae, width of keratinized mucosa, position of mucogingival junction relating to the surrounding tissues, and peri-implant radiolucency and marginal bone loss, which were evaluated radiographically.
  
  
  RESULTS
  The postsurgical healing period was uneventful for all patients. Soft tissue closure over the implant sites was achieved in 1 to 3 weeks after surgery at all sites. At second-stage surgery, no peri-implant bone defects were observed or detected by probing around all the experimental implants. The soft tissue anatomy was considered clinically acceptable in all patients.
  
  
  CONCLUSIONS
  Successful osseointegration and complete bone healing were observed for all patients. The soft tissue healing and morphology were satisfactory; additional mucogingival surgery was not required before definitive prosthetic rehabilitation.
authors.affiliation: Department of Biophysical, Medical and Dental Sciences and Technologies, Medical School, University of Genova, Italy.
authors.forename: Ugo
authors.initials: U
authors.lastname: Covani
authors.forename: Antonio
authors.initials: A
authors.lastname: Barone
authors.forename: Roberto
authors.initials: R
authors.lastname: Cornelini
authors.forename: Roberto
authors.initials: R
authors.lastname: Crespi
mesh_terms: D000328:Adult; D003758:Dental Implantation, Endosseous / Q000379:methods*; D019250:Dental Implants, Single-Tooth; D005260:Female; D005881:Gingiva / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000502:physiology; D016348:Osseointegration; D013997:Time Factors; D014081:Tooth Extraction; D020390:Tooth Socket; D014945:Wound Healing