title: Buccal bone plate remodeling after immediate implants with or without synthetic bone grafting and flapless surgery: a histomorphometric and fluorescence study in dogs.
abstract: OBJECTIVE
  The aim of this study was to evaluate the buccal bone plate remodeling after immediate implantation using the flapless approach with or without bone graft into the gap between the implant and the buccal bone.
  
  
  METHODS
  Eight dogs had the mandibular bicuspids extracted without flaps, and four implants were installed on each side, totaling eight implants per animal. Randomly, in one side, the implants were positioned at the bone crest level (equicrestal), and on the opposite side, the implants were positioned 2 mm subcrestal. All the implants were positioned 2.0 mm from the buccal bone plate (gap) and associated or not with grafting material. Therefore, the following treatments were performed: implants subcrestal test (SCTG) with bone graft and control (SCCG) without bone graft, and equicrestal test (ECTG) with bone graft and control (ECCG) without bone graft. One week following the surgeries, metallic prostheses were installed. Bone markers were administered 1, 2, 4, and 12 weeks after implant placement for fluorescence analysis. Ground sections were prepared from 12-week healing biopsies, and histomorphometry was performed.
  
  
  RESULTS
  The histomorphometric evaluation presents significant better results for the ECTG in the vertical crestal bone resorption, but the other parameters showed better results for the SCCG. The fluorescence evaluation in adjacent areas showed numerically different results between groups with a small decrease at 12 weeks, except for the SCCG, which was higher at this time. The distant area showed a continuous increase in the marked bone.
  
  
  CONCLUSIONS
  The equicrestally placed implants presented little or no loss of the buccal bone wall. The subcrestally positioned implants presented loss of buccal bone, regardless of the use of bone graft. However, the buccal bone was always coronal to the implant shoulder. Both the equicrestal and subcrestal groups were benefited in the early stages of bone healing as evidenced by the fluorescence analysis.
authors.affiliation: Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
authors.forename: Flávia A
authors.initials: FA
authors.lastname: Suaid
authors.forename: Arthur B
authors.initials: AB
authors.lastname: Novaes
authors.forename: Adriana C
authors.initials: AC
authors.lastname: Queiroz
authors.forename: Valdir A
authors.initials: VA
authors.lastname: Muglia
authors.forename: Adriana L G
authors.initials: AL
authors.lastname: Almeida
authors.forename: Márcio F M
authors.initials: MF
authors.lastname: Grisi
mesh_terms: D000539:Alveolar Process / Q000601:surgery; D000818:Animals; D001706:Biopsy; D015519:Bone Density; D016723:Bone Remodeling; D001862:Bone Resorption; D018786:Bone Substitutes; D016025:Bone Transplantation; D019250:Dental Implants, Single-Tooth; D004285:Dogs; D057893:Immediate Dental Implant Loading; D008334:Mandible / Q000601:surgery; D008856:Microscopy, Fluorescence; D014081:Tooth Extraction; D020390:Tooth Socket / Q000601:surgery; D014945:Wound Healing
chemical_list: D018786:Bone Substitutes