Cambios dimensionales en el alveolo tras inmediatos post extracción e injerto de conectivo

Resumo

The purpose of this investigation is to analyse the dimensional changes in the hard and soft tissues of the alveolus after the combination of immediate post-extraction implant and connective grafting and/or socket-shield technique. In the present single-center prospective cohort study a total of 15 patients were selected following the inclusion and exclusion criteria. In this way, patients with smoke habit, diabetes disease, immunological alterations or taking drugs affecting bone (e.g., Bisphosphonates) were excluded from the study. Healthy patients and patients without medical conditions that could affect bone remodeling were included. All patients included in this study accepted to participate after signing an informed consent. All of the interventions were explained to participants and they were able to understand the postoperative cares they had to carry out. Patients presented one or more teeth in the maxilla’s anterior area, which had a poor prognosis and had to be extracted and replaced by immediate implants. Some of the patients received more than one implant. Therefore, a total of 26 surgical sites were registered. During the surgery, along with the implant placement, a connective tissue graft was harvested and/or a socket shield technique was carried out. While performing either of the two techniques mentioned above, the patient's biotype was registered with a caliber. The bone crest dimensions were analyzed with a periodontal probe during surgery and using a CBCT radiological study immediately after implant placement and at check-ups. Post-operative measurements were undertaken based on the radiological images. After one year it was observed that an increase in the thickness of mucosa and buccal cortex occurred at 5 and 7 mm from the gingival margin. An increase in thickness of palatal bone was registered at 3 mm. This could be due to better horizontal maintenance in the buccal area by the presence either of the graft or the PET. From the results observed in this study, performance of CTG and PET as complementary techniques to the placement of immediate implants are sufficient for gaining and/or maintaining volume of peri-implant tissue in the vestibular area of the implants. Despite the limitations of the study, such as small sample size or the lack of aesthetic analysis of the cases, this study may serve as a starting point for future studies to evaluate the predictability of this type of technique in the long term.