Morphometric evaluation of the alveolar bone changes in immediate maxillary implant placement with socket defect

Abstract

Introduction: There are several surgical techniques for alveolar preservation, among which stands out the Tarnow technique, better known as "Ice Cream Cone", used in type II sockets, where the vestibular cortical is partially reduced after tooth extraction. The aim of this study is to determine the dimensional alterations that occurred in type II sockets, rehabilitated with immediate implants and with the "Ice Cream Cone" technique for buccal bone plate reconstruction. Materials and Methods: The present study was a retrospective observational analysis of immediate post-extraction implants placed in the anterior maxillary sector, that presented some type of bone defect associated with vestibular cortical bone. The patients were submitted to an intraoral optical
scanner (Cerec Omnicam®, Sirona Dental Systems GmbH, Bensheim, Germany), at different folow-up moments, which were: T0 (before tooth extraction); T1 (one month after implant placement); T2 (four months after implant placement); and T3 (one year after implant placement). The digital analysis protocol was performed as described in the literature and measurements of the linear and volumetric changes that occurred were conducted. A tomographic scan was conducted previously to the surgical procedure, so the dehiscence of the buccal cortical plate could be diagnosed. Results: Seventy patients with a mean age of 53.00±17.66 (ranging from 27 to 77 years), treated with 7 immediate unit implants, participated in this study. During the follow-up period, 6 patients
were observed after the first month of treatment, 4 were studied at 4 months after implant placement and 3 fulfilled the postoperative control established at 12 months after surgery. A variation of the total mean values with volumetric loss of 46.1 ±34.8mm3 (T0-T1), 30.7 ±42.3 mm3 (T0-T2) and 70±0.65 mm3 (T0-T3) were observed. Regarding changes in vestibule-palatine linear peri-implant tissues, mean loss values of 0.94±0.65 mm (T0-T1), 0.6 ±0.62 mm (T0-T2) and 0.89 ±0.60mm (T0-T3) were observed. The variation in the height
of the peri-implant mucosa obtained mean loss values at the level of the mesial papilla of 0,62±0,55mm, 0,64±0,53mm at the level of the distal papilla and 0,72±0,62mm at the level of the gingival margin, during the first year of follow-up period. Conclusion: The clinical results obtained demonstrate that this technique can be a valuable treatment option due to certain clinical conditions such has thick gingival biotype and absence of periodontal disease.

Date of Award	30 Jul 2021
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Tiago Borges (Supervisor) & Bruno Almeida (Co-Supervisor)