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.
Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. g.m.raghoebar@kchir.umcg.nl
G M
GM
Raghoebar
J J H
JJ
Slater
L den
Ld
Hartog
H J A
HJ
Meijer
A
A
Vissink
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