Abstract
Defects in the layer of buccal bone lead to its loss after tooth extractions. This
requires hard tissue grafting before implants can be put in place. The aim of this
study was to evaluate the stability of hard tissue grafts inserted at the same time
as the teeth were extracted. Teeth had to be extracted because of defects in the buccal
bone. Extractions were combined with preservation of the ridge using autogenous and
artificial bone. A combination epithelialised and subepithelial connective tissue
graft was used to seal the socket. Wound healing was assessed and the width of the
alveolar crest was measured after hard tissue grafting and during insertion of the
implants. We studied 39 patients (20 female, 19 male, mean (SD) age 41 (7.9) years)
who had 43 teeth extracted together with preservation of the ridge. One patient failed
to attend for placement of the implant. Thirty-nine implants were inserted 5.3 (0.4)
months after preservation of the ridge. Two patients developed partial necrosis of
the combination graft, but in all other cases primary wound healing was uneventful.
In three cases the bone grafts failed to consolidate. The mean (SD) width of the alveolar
crest was after bone grafting 6.80 (1.20) mm and during insertion of implants 5.65
(1.50) mm; the mean resorption of the bone grafts was 1.2 (1.1) mm. We conclude that
bone grafting to rebuild buccal alveolar defects at the same time that the tooth is
extracted, combined with a soft tissue graft to seal the socket, showed promising
results and could be an alternative treatment to delayed hard tissue grafting.
Keywords
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Article info
Publication history
Published online: October 17, 2011
Accepted:
September 20,
2011
Identification
Copyright
© 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
