title: Buccal bone deficiency in fresh extraction sockets: a prospective single cohort study.
abstract: OBJECTIVE
  The purpose of this prospective single cohort study was to evaluate the use of xenograft and collagen membranes in treating full or partial buccal bone defects of fresh extraction sockets in the esthetic zone.
  
  
  METHODS
  Thirty-three patients requiring tooth extraction in the anterior maxillary area and showing a complete or partial buccal bone plate deficiency (more than 2 mm) were consecutively enrolled and treated. Corticocancellous porcine bone and platelet-rich fibrin (PRF) with a collagen membrane were used to graft the extraction sockets, and the membranes were left exposed to the oral cavity with a secondary soft tissue healing. The outcome variables were as follows: width of keratinized mucosa, facial soft tissue levels, clinical bone changes (measured with a clinical splint), implant and prosthesis failures, and peri-implant marginal bone changes.
  
  
  RESULTS
  All treated sites allowed the placement of implants; the width of keratinized mucosa at the mid-facial aspect showed an increase of 2.3 mm 5 months after the grafting procedure, and its value was 3.2 ± 0.6 mm at 1-year follow-up. The mean values of the facial soft tissue level indicated an increase over time. The bone level showed an improvement of 0.8 ± 0.1 mm and 0.7 ± 0.1 mm at mesial and distal sites, respectively, when compared to the baseline measurements. Finally, in the palatal area, no bone changes were observed. No implant failed during the entire observation period.
  
  
  CONCLUSIONS
  Findings from this study showed that xenograft and PRF, used for ridge preservation of the extraction sockets with buccal bone plate dehiscence in the esthetic zone, can be considered effective in repairing bone defects before implant placement. The secondary soft tissue healing over the grafted sockets did not compromise bone formation; moreover, the soft tissue level and the width of keratinized gingiva showed a significant improvement over time.
authors.affiliation: Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Barone
authors.affiliation: Tuscan Dental Institute, Versilia General Hospital, Lido di Camaiore, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Ricci
authors.affiliation: School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA.
authors.forename: Georgios E
authors.initials: GE
authors.lastname: Romanos
authors.affiliation: Department of Dentistry, University of Florence, Florence, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Tonelli
authors.affiliation: Tuscan Dental Institute, Versilia General Hospital, Lido di Camaiore, Italy.
authors.forename: Fortunato
authors.initials: F
authors.lastname: Alfonsi
authors.affiliation: Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy.|Tuscan Dental Institute, Versilia General Hospital, Lido di Camaiore, Italy.
authors.forename: Ugo
authors.initials: U
authors.lastname: Covani
mesh_terms: D000328:Adult; D016301:Alveolar Bone Loss / Q000601:surgery*; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D000818:Animals; D016025:Bone Transplantation / Q000379:methods*; D003094:Collagen / Q000627:therapeutic use; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged; D011446:Prospective Studies; D013552:Swine; D014081:Tooth Extraction; D020390:Tooth Socket / Q000601:surgery*; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: C106416:Bio-Gide; D015921:Dental Implants; D003094:Collagen
keywords: alveolar socket; bone augmentation; bone remodeling; platelet-rich fibrin; ridge preservation