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Long-Term Bone Dimensional Changes Following Flapless Immediate Implant Placement
Sponsor: International Dental Contiuing Education
Summary
Nowadays, achieving long-term hard tissue stability is the definitive goal of a successful immediate implant placement and has become the optimal challenge for clinicians over the past few decades. It is wellestablished that the dimensional changes and remodeling of the alveolar ridge represent a physiologic sequela of tooth extraction and is inevitable especially the labial bone wall. This creates an unfavorable labio-palatal discrepancy and produces the "fixture-socket gap" around the coronal portion of the implant, known as the labial gap especially in sockets with thin bone.Although this gap has the potential to repair spontaneously in some cases, still previous studies reported that this gap cannot be completely filled without using a regenerative material. It has been claimed that buccal/labial gap augmentation contributes to the final esthetic success of the dental implant, where the regenerative material acts as a scaffold to maintain the blood clot, promote bone formation, compensate for the postextraction socket remodeling and maintain the buccal bone thickness and thereby preventing the buccal contour collapse. Nevertheless, this would add an additional cost and prolong the surgical procedure. Meanwhile, there is a controversy in the existing literature regarding the actual benefit of using bone grafts in the buccal gap. Previous systematic reviews concluded that there is not sufficient evidence to prove that immediate implant placement with grafting the labial gap, would comprise an additional benefit in preventing alveolar ridge reduction and contour collapse. Furthermore, previous controlled clinical trials reported that evidence for this additional treatment is still unclear.
Official title: Long-Term Bone Dimensional Changes Following Flapless Immediate Implant Placement With or Without Bone Grafting: A 5 Years Follow up of a Randomized Clinical Trial
Key Details
Gender
All
Age Range
21 Years - 54 Years
Study Type
INTERVENTIONAL
Enrollment
40
Start Date
2026-10-01
Completion Date
2026-12
Last Updated
2026-09-10
Healthy Volunteers
No
Conditions
Interventions
IIP+Bone graft + CHA
A tapered screw-vent bone level implant (Zimmer implant TSV, IN, USA) was inserted into the extraction socket in a flapless manner, engaging 3-4 mm of the sound intact apical and palatal bone to achieve primary stability using the motor and manual torque wrench which was set to be at least 35 N cm to allow nonfunctional immediate loading. The implant platform was located 1.5 mm subcrestal or equicrestal to the labial bone and the implant diameter was selected to leave a labial gap of at least 1.5 mm. Following implant placement, randomization sequence with allocation to either graft or no graft group was revealed. For patients assigned to receive a graft, demineralized bovine bone graft (Bio-Oss, Geistlich Pharma AG, Wolhusen, Switzerland) was placed in the gap labial to the implant to the level of the implant platform.
IIP +CHA only
A tapered screw-vent bone level implant (Zimmer implant TSV, IN, USA) was inserted into the extraction socket in a flapless manner, engaging 3-4 mm of the sound intact apical and palatal bone to achieve primary stability using the motor and manual torque wrench which was set to be at least 35 N cm to allow nonfunctional immediate loading. The implant platform was located 1.5 mm subcrestal or equicrestal to the labial bone and the implant diameter was selected to leave a labial gap of at least 1.5 mm. Following implant placement, randomization sequence with allocation to either graft or no graft group was revealed. For patients assigned to receive no graft an immediate anatomical customized healing abutment fabricated by adding flowable composite to the temporary cylindrical abutment mimicking the mimicking the shape of the socket at the marginal gingiva was screwed to the implant
Locations (1)
International Dental Continuing Education (IDCE) Research Institute
Cairo, Egypt