Comparison of procedures for immediate reconstruction of large osseous defects resulting from removal of a single tooth to prepare for insertion of an endosseous implant after healing.
This study evaluated the treatment outcome of immediate reconstruction of 45 large osseous defects resulting from removal of a single tooth with a 1:2 mixture of Bio-Oss and autologous tuberosity bone, and three different procedures for soft tissue closing (Bio-Gide membrane, connective tissue graft, full-thickness palatal mucosa graft; n=15 per group). All defects had an unfavourable osseous-gingival relationship and vertical bone loss of >5mm. The hard and soft tissues were immediately reconstructed after removal of the tooth. Implants were inserted after 3 months. Patients' acceptance, complications and postoperative morbidity were prospectively evaluated by standardized clinical and radiographic examinations up to 12 months after the augmentation procedure. The patients completed a questionnaire on subjective complaints related to the procedure. All hard-soft tissue procedures resulted in sufficient bone volume for the insertion of implants and a favourable aesthetic outcome. The gingival mid-buccal aesthetics before, and 1 year after, treatment significantly favoured the full-thickness palatal mucosa graft, showing a gain in gingival contour of 0.5+/-0.8mm; the other procedures resulted in a 1.2+/-1.6mm decrease. Of the procedures evaluated, a full-thickness palatal mucosa graft was the most predictable for immediate reconstruction of the socket after tooth removal.
Raghoebar
G M
GM
Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. g.m.raghoebar@kchir.umcg.nl
Slater
J J H
JJ
Hartog
L den
Ld
Meijer
H J A
HJ
Vissink
A
A
D000328:Adult; D016301:Alveolar Bone Loss / Q000209:etiology / Q000601:surgery*; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D018786:Bone Substitutes; D016025:Bone Transplantation; D003094:Collagen; D003238:Connective Tissue / Q000637:transplantation; D003442:Crowns; D003758:Dental Implantation, Endosseous; D019250:Dental Implants, Single-Tooth; D019094:Dental Prosthesis, Implant-Supported; D003831:Denture, Partial, Immediate; D005260:Female; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery; D008567:Membranes, Artificial; D008875:Middle Aged; D008903:Minerals; D009061:Mouth Mucosa / Q000637:transplantation; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods; D011795:Surveys and Questionnaires; D014081:Tooth Extraction / Q000009:adverse effects / Q000379:methods; D020390:Tooth Socket / Q000601:surgery; D055815:Young Adult
C106416:Bio-Gide; C077540:Bio-Oss; D018786:Bone Substitutes; D008567:Membranes, Artificial; D008903:Minerals; D003094:Collagen