Journal of Oral Implantology December 2012 - (Page 687)

RESEARCH Buccal Bone Plate Remodeling After Immediate Implant Placement With and Without Synthetic Bone Grafting and Flapless Surgery: Radiographic Study in Dogs Arthur B. Novaes Jr, DSc1* ´ Flavia Suaid, DSc1 Adriana C. Queiroz, DSc1 Valdir A. Muglia, DSc2 ´rgio L. S. Souza, DSc1 Se Daniela B. Palioto, DSc1 ´ Mario Taba Jr, DSc1 ´ Marcio F. M. Grisi, DSc1 Recent studies in animals have shown pronounced resorption of the buccal bone plate after immediate implantation. The use of flapless surgical procedures prior to the installation of immediate implants, as well as the use of synthetic bone graft in the gaps represent viable alternatives to minimize buccal bone resorption and to favor osseointegration. The aim of this study was to evaluate the healing of the buccal bone plate following immediate implantation using the flapless approach, and to compare this process with sites in which a synthetic bone graft was or was not inserted into the gap between the implant and the buccal bone plate. Lower bicuspids from 8 dogs were bilaterally extracted without the use of flaps, and 4 implants were installed in the alveoli in each side of the mandible and were positioned 2.0 mm from the buccal bone plate (gap). Four groups were devised: 2.0-mm subcrestal implants (3.3 3 8 mm) using bone grafts (SCTG), 2.0-mm subcrestal implants without bone grafts (SCCG), equicrestal implants (3.3 3 10 mm) with bone grafts (ECTG), and equicrestal implants without bone grafts (ECCG). One week following the surgical procedures, metallic prostheses were installed, and within 12 weeks the dogs were sacrificed. The blocks containing the individual implants were turned sideways, and radiographic imaging was obtained to analyze the remodeling of the buccal bone plate. In the analysis of the resulting distance between the implant shoulder and the bone crest, statistically significant differences were found in the SCTG when compared to the ECTG (P ¼ .02) and ECCG (P ¼ .03). For mean value comparison of the resulting linear distance between the implant surface and the buccal plate, no statistically significant difference was found among all groups (P . .05). The same result was observed in the parameter for presence or absence of tissue formation between the implant surface and buccal plate. Equicrestally placed implants, in this methodology, presented little or no loss of the buccal bone. The subcrestally positioned implants presented loss of buccal bone, even though synthetic bone graft was used. The buccal bone, however, was always coronal to the implant shoulder. Key Words: immediate implant, synthetic bone graft, tooth socket, tooth extraction, gap filling INTRODUCTION Department of Bucco-Maxillo-Facial Surgery and Traumatology ˜ and Periodontology, School of Dentistry of Ribeirao Preto, ˜ ˜ University of Sao Paulo, Sao Paulo, SP, Brazil. 2 Department of Dental Materials and Prothesis, School of ˜ ˜ ˜ Dentistry of Ribeirao Preto, University of Sao Paulo, Sao Paulo, SP, Brazil. * Corresponding author, e-mail: novaesjr@forp.usp.br DOI: 10.1563/AAID-JOI-D-10-00176 1 S ince the early dental implant installation techniques, innumerable modifications have been proposed in order to reach faster, less invasive, and more esthetic ways to restore missing teeth. One of Journal of Oral Implantology 687

Table of Contents for the Digital Edition of Journal of Oral Implantology December 2012

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Lateral Augmentation of the Maxilla and Mandible Using Framework Technique With Allogeneic Bone Grafts
Accuracy of Cone Beam Computerized Tomography and a Three-Dimensional Stereolithographic Model in Identifying the Anterior Loop of the Mental Nerve: A Study on Cadavers
Evaluation of Microgap Size and Microbial Leakage in the Connection Area of 4 Abutments With Straumann (ITI) Implant
Buccal Bone Plate Remodeling After Immediate Implant Placement With and Without Synthetic Bone Grafting and Flapless Surgery: Radiographic Study in Dogs
Evaluation of Soft Tissues Around Single Tooth Implants in the Anterior Maxilla Restored With Cemented and Screw-Retained Crowns
Accuracy of a Newly Developed Cone-Beam Computerized Tomography-Aided Surgical Guidance System for Dental Implant Placement: An Ex Vivo Study
Nasopalatine Canal Position Relative to the Maxillary Central Incisors: A Cone Beam Computed Tomography Assessment
Esthetics in Implant-Supported Prostheses: A Literature Review
Reliability of Implant Surgical Guides Based on Soft-Tissue Models
Clinical Evaluation of Short and Wide-Diameter Implants Immediately Placed Into Extraction Sockets of Posterior Areas: A 2-Year Retrospective Study
Single Stage Immediate Implant Placements in the Esthetic Zone
Removal of Fractured Dental Implant Screw Using a New Technique: A Case Report
Restoration of Failing Maxillary Implant-Supported Fixed Prosthesis With Cross Arch Splinted Unilateral Zygomatic Implant: A Clinical Report
Oral Rehabilitation of Severe Dentoalveolar Trauma: A Clinical Report
Implant Installation With Bone Augmentation and Transmucosal Healing With Demineralized Human Cortical Bone in the Maxillary Anterior Region: Report of 3 Cases
Bone Morphogenic Protein: An Elixir for Bone Grafting—A Review
Orthodontic Considerations in Restorative Management of Hypodontia Patients With Endosseous Implants
Squamous Cell Carcinoma in Association With Dental Implants: An Assessment of Previously Hypothesized Carcinogenic Mechanisms and a Case Report
Indirect Osteotome Maxillary Sinus Floor Elevation: An Update
Reliability of Implant Surgical Guides Based on Soft-Tissue Models: A Methodological Mistake

Journal of Oral Implantology December 2012