Impact of Soft Tissue Grafts on Tissue Alterations After Immediate Tooth Replacement

Soft and Hard Tissue Stability After Immediate Tooth Replacement With Implant in Fresh Sockets Grafted With Different Soft Tissue Grafts

This study evaluates the impact of soft tissue grafts on soft tissue recession following immediate implant, provisional and bone graft placement in compromised sockets. One third of the patients received a collagen matrix (CM group), another third received a connective tissue graft removed from the palate (CTG group) and the final third did not receive any soft tissue graft (CTL group).

Preventing soft tissue recession following flapless immediate implant and provisional placement (IIPP) in sockets with facial bone dehiscences is a challenge, mainly in esthetic areas. This study evaluated the impact of soft tissue grafts on peri-implant alterations after 1-year follow-up. Twenty-four patients with one single failing maxillary incisor presenting facial bone dehiscence and receiving IIPP were randomly divided in three groups (n= 8 in each group): Control (CTL); Collagen Matrix (CM); Connective tissue graft (CTG). In addition to soft tissue grafts, all groups were treated with collagen membrane and deproteinized bovine bone mineral containing 10% of porcine collagen. Clinical, photographic and tomographic analyses were performed at baseline, 6 and 12 months after surgery to evaluate tissue alterations.

Inclusion Criteria:

• Presence of a failing maxillary incisor with neighbouring teeth and harmonic gingival contour;
• Operated area with appropriate palatal/apical bone to install the implant;
• A buccal wall defect confirmed by cone beam computed tomography;
• Clinical attachment level > 3 mm;
• Good oral hygiene with visible plaque index < 20%;
• No bone loss in the neighbouring teeth;
• Implant primary stability > 32N

Exclusion Criteria:

• History of periodontal surgeries in the failing tooth;
• Occlusal instability;
• Systemic alterations that could compromise the surgical procedure, such ass smokers, bruxists; drug users; patients with diabetes or pregnants.
• Active infection involving the gingival margin
• Patients undergoing radiotherapy in the head and neck area. Patients presented history of bone associated diseases or medication affecting bone metabolism;