Immediate implant placement in intact fresh extraction sockets vs sockets with vestibular bony dehiscence in the aesthetic area: comparison of two clinics

The treatment of excellence to replace missing teeth that has been chosen over the last few years is the dental implant. Many advances have been achieved in all these years in the osteointegration of these implants. The immediate implant placement is becoming increasingly well-known especially because it reduces the number of visits of the patient needs and, consequently, the cost of the treatment. However, immediate implant therapy is a technically sensitive approach and the clinicians should know that to do this procedure, proper planning of the case is mandatory. Several factors can significantly affect the final outcomes when performing immediate implant therapy after tooth extraction, for example the integrity or not of the buccal wall of the alveolus socket. It has been described as relevant factors the 3D implant positioning into the socket, the primary stability of the implant, the combination or not with regenerative procedures or the use or not of immediate provisional restorations. The most referred complication when applying immediate implant protocols is the recession of the facial soft tissue. So all efforts are centered on applying protocols that can minimize the bone remodeling, and consequently the soft tissue changes after tooth extraction. As far as we know not only can the surgical protocols have a big impact on the final aesthetics, but prosthetic protocols can, too. Objectives: The aim of this scientific communication is to evaluate the changes in the volume of the peri-implant bone and gingival tissue after an immediate implant placement and a connective tissue graft in patients with an intact alveolar socket versus sockets where the facial soft tissue is present, but the buccal plate is partially missing. Materials and methods: Implants will be placed in this study, in the aesthetic zone, anterior maxilla (World Dental Federation notation FDI) positions 15-25. All the patients included in the study will require single tooth extraction due to a variety of reasons including: advanced carious lesions, periodontally hopeless teeth, dental trauma, root fracture or non-retractable endodontic failure. The assignment of the control group and the study group will be controlled. In the control group only intact buccal bony wall (Type I Elian Socket) will be included; in the test group, compromised alveolar socket with vestibular bony dehiscence (Type II Elian Socket) will be included.