Human mineralized bone in extraction sites before implant placement: preliminary results

BACKGROUND: Bone loss after tooth extraction may prevent dental implant placement. Human mineralized bone grafts can be used to restore bone volume and allow for tooth replacement with dental implants. METHODS: The authors grafted 22 sites in 18 patients with human mineralized bone after tooth extraction. They allowed molar sites 16 weeks for graft healing, placed the implants and restored them with a final crown after a four-month integration period. Single-rooted maxillary sites received implants and immediate placement of provisional crowns or underwent a delayed two-stage restoration approach. The authors used radiographs and clinical examinations to evaluate the results. RESULTS: All of the sites were restored successfully with a single-tooth implant restoration. Periapical radiographs indicated that the crestal bone levels were limited to the first thread of the implants or slightly coronal to the first thread of the implant. Clinical evaluation indicated excellent gingival health around the provisional and final restorations, without obvious gingival migration. CONCLUSIONS: The use of human mineralized bone may have significant potential to reconstruct missing bone resulting from tooth extraction and to preserve bone after tooth extraction. In addition, healed bone graft sites seem to be able to support immediate placement of a provisional crown and implant restorations. CLINICAL IMPLICATIONS: Patients who are having teeth extracted may become candidates for implant restorations when the sites are appropriately grafted to preserve and reconstruct bone volume, thus allowing for more options for reconstructing the missing tooth site.