title: Socket grafting with or without buccal augmentation with anorganic bovine bone at immediate post-extractive implants: 6-month after loading results from a multicenter randomised controlled clinical trial.
abstract: OBJECTIVE
  To evaluate whether grafting with additional anorganic bovine bone to augment horizontally the buccal plate (internal and external grafting [IEG]) at single post-extractive implants preserves the alveolar ridge, improving aesthetics, better than internal socket grafting alone (ISGA).
  
  
  METHODS
  A total of 78 patients, treated in four Italian private practices, requiring a single immediate post-extractive implant, having at least 1 mm of implant-to-buccal bone gap after implant insertion and a preserved buccal bone, had the residual bone-to-implant gap filled with anorganic bovine bone. Thirty-nine randomly allocated patients received additional buccal horizontal augmentation of about 2 mm thickness with the same bone substitute (IEG group) covered with collagen resorbable membranes. Implants were submerged for 4 months before being loaded with provisional acrylic crowns. Definitive crowns were delivered after 6 months. Outcome measures were crown/implant failures, complications and aesthetics recorded by blinded assessors 6 months after initial loading, at delivery of definitive crowns.
  
  
  RESULTS
  Six months after initial loading, 8 patients dropped out, did not complete the treatment or were treated twice and therefore had to be excluded (4 from each group). There were no statistically significant differences for implant failures and complications between the two groups. Two implants failed in the IEG group versus 1 in the ISGA group. Four complications occurred, 2 in each group. The mean implant aesthetic score (IAS) was 7.8 at ISGA sites and 8.0 at IEG sites. There were no statistically significant differences between the two groups (P = 0.492; difference 0.2 mm; 95% CI -0.769, 0.369) for IAS score. There were no statistically significant differences in the outcomes between the centres.
  
  
  CONCLUSIONS
  The use of adjunctive anorganic bovine bone placed buccally at preserved buccal sites of immediate post-extractive implants may not improve the aesthetic outcome, however additional research is needed to confirm or reject these preliminary findings.
authors.forename: Francesco
authors.initials: F
authors.lastname: Zuffetti
authors.forename: Marco
authors.initials: M
authors.lastname: Esposito
authors.forename: Matteo
authors.initials: M
authors.lastname: Capelli
authors.forename: Fabio
authors.initials: F
authors.lastname: Galli
authors.forename: Tiziano
authors.initials: T
authors.lastname: Testori
authors.forename: Massimo
authors.initials: M
authors.lastname: Del Fabbro
mesh_terms: D000328:Adult; D016301:Alveolar Bone Loss / Q000209:etiology / Q000517:prevention & control*; D000540:Alveolar Ridge Augmentation / Q000009:adverse effects / Q000379:methods; D000704:Analysis of Variance; D000818:Animals; D018786:Bone Substitutes; D002417:Cattle; D016009:Chi-Square Distribution; D003442:Crowns; D003758:Dental Implantation, Endosseous / Q000379:methods*; D019250:Dental Implants, Single-Tooth; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003830:Denture, Partial, Fixed; D004955:Esthetics, Dental; D005260:Female; D048091:Guided Tissue Regeneration; D006801:Humans; D008297:Male; D008903:Minerals; D016348:Osseointegration; D016037:Single-Blind Method; D013499:Surface Properties; D013997:Time Factors; D020390:Tooth Socket / Q000601:surgery*; D055815:Young Adult
chemical_list: C077540:Bio-Oss; D018786:Bone Substitutes; D008903:Minerals