Correction of Buccal Dehiscence During Immediate Implant Placement Using the Flapless Technique: A Tomographic Evaluation.
The aim of this study was to evaluate a new technique for treating dehiscence buccal bone sites (Class II) with immediate implant and collagen-enriched bovine-derived xenograft blocks without a surgical flap or membrane.



Individuals with at least 5 mm of buccal bone dehiscence were selected for a flapless surgical approach to insert xenograft blocks into buccal dehiscence defects as well as the gap between implant and residual bone wall. No membrane was used. Buccal bone wall height was measured by computed tomography in the preoperative period (T0) and 6 to 12 months after procedure (T1). Likewise, buccal-lingual width of alveolar ridge as well as thickness of buccal wall was compared with the contralateral tooth.



Fourteen patients were selected. Buccal wall height at T1 was not significantly different after 6 to 12 months between the treated and contralateral teeth, although both were greater than T0 (P <0.01). The heights ranged from 6.4 to 16.30 mm at T0, 12.8 to 25.6 mm at T1, and 14.8 to 25.29 mm in the contralateral teeth. Significant differences were observed between treated teeth (T1) and their contralateral, both buccal-lingually in the alveolar ridge (P = 0.007) and in buccal wall thickness (P = 0.003). Wall thickness ranged from 0.9 mm to 3.81 mm at T1 and 0.25 mm to 1.60 mm in the contralateral teeth.



Immediate implant placement at dehiscence buccal bone sites using flapless surgery combined with xenograft blocks provided complete formation of the buccal bone wall up to the implant shoulder.
Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil.|Department of Restorative Dentistry, São Leopoldo Mandic Institute and Dental Research Center, Campinas, Brazil.
Jamal Hassan
JH
Assaf
Private practice, Santa Maria, Brazil.
Débora do Canto
DD
Assaf
Department of Periodontology, School of Dentistry, Franciscan University Center, Santa Maria, Brazil.
Raquel Pippi
RP
Antoniazzi
Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil.
Leandro Berni
LB
Osório
Department of Restorative Dentistry, São Leopoldo Mandic Institute and Dental Research Center, Campinas, Brazil.
Fabiana Mantovani Gomes
FM
França
D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging* / Q000601:surgery*; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001862:Bone Resorption / Q000601:surgery*; D005260:Female; D064593:Heterografts; D006801:Humans; D057893:Immediate Dental Implant Loading; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
Bone regeneration; guided tissue regeneration; immediate dental implant loading