title: Hard-tissue alterations following immediate implant placement in extraction sites.
abstract: BACKGROUND
  The marginal gap that may occur following implant installation in an extraction socket may be resolved by hard-tissue fill during healing.
  
  
  OBJECTIVE
  To study dimensional alterations of hard tissues that occur following tooth extraction and immediate placement of implants.
  
  
  METHODS
  Eighteen subjects with a total of 21 teeth scheduled for extraction were included. Following flap elevation and the removal of a tooth and implant installation, clinical measurements were made to characterize the dimension of the surrounding bone walls, as well as the marginal defect. No membranes or filler material was used. The flaps were subsequently replaced and secured with sutures in such a way that the healing cap of the implant was exposed to the oral environment. After 4 months of healing a re-entry procedure was performed and the clinical measurements were repeated.
  
  
  RESULTS
  Fifty-two marginal defects exceeding 3 mm were present at baseline: 21 at buccal, 17 at lingual/palatal, and 14 at approximal surfaces. At the re-entry eight defects exceeding 3.0 mm remained. During the 4 months of healing, the bone walls of the extraction underwent marked change. The horizontal resorption of the buccal bone dimension amounted to about 56%. The corresponding resorption of the lingual/palatal bone was 30%. The vertical bone crest resorption amounted to 0.3+/-0.6 mm (buccal), 0.6+/-1.0 mm (lingual/palatal), 0.2+/-0.7 mm (mesial), and 0.5+/-0.9 mm (distal).
  
  
  CONCLUSIONS
  The marginal gap that occurred between the metal rod and the bone tissue following implant installation in an extraction socket may predictably heal with new bone formation and defect resolution. The current results further documented that marginal gaps in buccal and palatal/lingual locations were resolved through new bone formation from the inside of the defects and substantial bone resorption from the outside of the ridge.
authors.affiliation: Department of Periodontology, Institute of Odontology, Sahlgrenska Academy at Gothenburg University, Göteborg, Sweden. daniele.botticelli@odontologi.gu.se
authors.forename: Daniele
authors.initials: D
authors.lastname: Botticelli
authors.forename: Tord
authors.initials: T
authors.lastname: Berglundh
authors.forename: Jan
authors.initials: J
authors.lastname: Lindhe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001861:Bone Regeneration; D001862:Bone Resorption / Q000209:etiology / Q000473:pathology; D003757:Dental Implantation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014081:Tooth Extraction; D020390:Tooth Socket / Q000033:anatomy & histology*