title: Connective tissue grafts in conjunction with implants installed immediately into extraction sockets. An experimental study in dogs.
abstract: OBJECTIVE
  To evaluate the influence of a sub-epithelial connective tissue graft placed at the buccal aspect of implants installed immediately after tooth extraction on the dimensional changes of hard and soft tissues.
  
  
  METHODS
  In six Labrador dogs a bilateral partial- thickness dissection was made buccal to the second mandibular premolar. At the lingual aspect, full-thickness flaps were elevated. The teeth were extracted and implants installed immediately into the distal socket. A connective tissue graft was obtained from the palate and applied to the buccal aspect of the test sites, whereas contra-laterally, no graft was applied. The flaps were sutured to allow a non-submerged installation. After 4 months of healing, the animals were sacrificed, ground sections were obtained and histomorphometric analyses were performed.
  
  
  RESULTS
  After 4 months of healing, all implants were integrated (n = 6). Both at the test and at the control sites bone resorption occurred: 1.6 mm and 2.1 mm, respectively. The difference was not statistically significant. The coronal aspect of the peri-implant soft tissue was wider and located more coronally at the test compared with the control sites. The differences were statistically significant.
  
  
  CONCLUSIONS
  The application of a connective tissue graft placed at the buccal aspect of the bony wall at implants installed immediately after tooth extraction yielded a minimal preservation of the hard tissues. The peri-implant mucosa, however, was significantly thicker and more coronally positioned at the test compared with the control sites.
authors.affiliation: UNESP-Universidade Estadual Paulista, Araçatuba Dental School, Aracatuba, Brazil.
authors.forename: Marco
authors.initials: M
authors.lastname: Caneva
authors.forename: Daniele
authors.initials: D
authors.lastname: Botticelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Viganò
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Morelli
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Rea
authors.forename: Niklaus P
authors.initials: NP
authors.lastname: Lang
mesh_terms: D016301:Alveolar Bone Loss / Q000517:prevention & control; D000818:Animals; D001641:Bicuspid; D003238:Connective Tissue / Q000637:transplantation*; D015921:Dental Implants; D004285:Dogs; D057893:Immediate Dental Implant Loading; D008334:Mandible / Q000601:surgery; D016348:Osseointegration; D013524:Surgical Flaps; D014081:Tooth Extraction; D020390:Tooth Socket / Q000601:surgery*
chemical_list: D015921:Dental Implants