Comparison of procedures for immediate reconstruction of large osseous defects resulting from removal of a single tooth to prepare for insertion of an endosseous implant after healing |
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| Authors: | GM Raghoebar JJH Slater L den Hartog HJA Meijer A Vissink |
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| Institution: | 1. Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands;2. Faculty of Medical Sciences, Dental School, Department of Prosthodontics, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands;3. Faculty of Medical Sciences, Dental School, Department of Oral Health Care and Clinical Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands;1. Department of Periodontics, Government Dental College and Research Institute, Bangalore 560002, Karnataka, India;2. Department of Conservative Dentistry and Endodontics, Government Dental College and Research Institute, Bangalore 560002, Karnataka, India;1. Department of Maxillofacial Surgery (Head: Prof. Dr. Dr. H. Schliephake), University of Goettingen, Germany;2. Department of Maxillofacial Surgery, Ludwig – Maximilians – University of Munich, Germany;3. Department of Anesthesiology, University of Goettingen, Germany;1. Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Southern California, Los Angeles, CA, USA;2. Orthodontics, Warwick Dentistry, Warwick Medical School, University of Warwick, Coventry, UK;1. Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. Siegmar Reinert, MD, DMD, PhD), University Hospital Tuebingen, Osianderstrasse 2-8, 72076 Tuebingen, Germany;2. Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. Rainer Schmelzeisen, MD, DMD, PhD), University Hospital Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany;1. Faculty of Dentistry, Oral and Maxillofacial Surgery Department, Cairo University, Egypt;2. Faculty of Dentistry, Oral and Maxillofacial Surgery Department, M.S.A University, Cairo, Egypt;3. Faculty of Dentistry, Oral and Maxillofacial Surgery Department, Al Faraby University, Jeddah, Saudi Arabia |
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| Abstract: | This study evaluated the treatment outcome of immediate reconstruction of 45 large osseous defects resulting from removal of a single tooth with a 1:2 mixture of Bio-Oss® and autologous tuberosity bone, and three different procedures for soft tissue closing (Bio-Gide® membrane, connective tissue graft, full-thickness palatal mucosa graft; n = 15 per group). All defects had an unfavourable osseous–gingival relationship and vertical bone loss of >5 mm. The hard and soft tissues were immediately reconstructed after removal of the tooth. Implants were inserted after 3 months. Patients’ acceptance, complications and postoperative morbidity were prospectively evaluated by standardized clinical and radiographic examinations up to 12 months after the augmentation procedure. The patients completed a questionnaire on subjective complaints related to the procedure. All hard–soft tissue procedures resulted in sufficient bone volume for the insertion of implants and a favourable aesthetic outcome. The gingival mid-buccal aesthetics before, and 1 year after, treatment significantly favoured the full-thickness palatal mucosa graft, showing a gain in gingival contour of 0.5 ± 0.8 mm; the other procedures resulted in a 1.2 ± 1.6 mm decrease. Of the procedures evaluated, a full-thickness palatal mucosa graft was the most predictable for immediate reconstruction of the socket after tooth removal. |
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