Evaluation of Using Connective Tissue Graft as a Biological Barrier to Cover Immediately Placed Implants in Maxillary Anterior Region

Islam Saad^1, and Suzan Salem²

¹Department of Periodontology and Oral Medicine, College of Dentistry, Qassim University, KSA

²Department of Oral Surgery, Maxillofacial and Diagnostic Science, College of Dentistry, Qassim University, KSA

Cite this paper:
Islam Saad and Suzan Salem. Evaluation of Using Connective Tissue Graft as a Biological Barrier to Cover Immediately Placed Implants in Maxillary Anterior Region. International Journal of Dental Sciences and Research. 2017; 5(3):39-48. doi: 10.12691/ijdsr-5-3-1

Abstract

Objective: The placement of dental implants immediately after tooth extraction has proven to be a predictable treatment protocol with a very high success rate. However, despite the high success rates achieved with osseointegrated implants, there are some disadvantages that could jeopardize the success of an immediate implant procedure. In particular, in the esthetic zone, bone morphology, level of crestal and interproximal bone, and morphology of the gingival tissues must be considered before initiating treatment. The aim of this study was to evaluate clinically and radiographically the effect of using connective tissue graft as a biological barrier to cover immediately placed dental implants in maxillary anterior region. Subjects and Methods: Fourteen patients were selected from the Department of Oral medicine, and Periodontology, Faculty of Dentistry, Alexandria University, Egypt. All pateints were indicated for tooth extraction and presence of sufficient apical bone to guarantee implant primary stability. They patients were undergo immediately placed implant after atraumatic tooth extraction and connective tissue graft is used to provide implant coverage. All patients were evaluated clinically at 1^st and 3^rd month after loading for modified paque index (mPI), modified gingival index (mGI) and prei-implant probing depth (PPD). Also radiographical evaluation to assess marginal bone height and to measure bone density around the implants done immediately postoperative and at 3^rd month after implant placement and at 1^st and 3^rd month after implant loading. Results: the results of this study showed that the mean mPI was 1.71 ± 1.11 and 1.29 ± 0.76 at 1 and 3 months respectively. The mean mGI was 0.89 ± 0.63 and 0.43 ± 0.43 at 1^st and 3^rd month respectively, this decrease in the mean modified gingival index score from the 1^st to the 3^rd month was statistically significant (Z= 2.39, p= 0.02). The mean PPD for was 1.75 ± 0.20 and 1.25 ± 0.19 at 1^st and 3^rd month respectively, this decrease in the mean probing depth score from the 1^st to the 3^rd month was found to be statistically significant (t= 6.41, p= 0.001). Radiographic result showed, the mean radiographic marginal bone height was 77.79 ± 1.11, 77.93 ± 1.08, 78.15 ± 1.01 and 78.42 ± 0.97 at immediate postoperative, 3^rd month of implant placement, 1^st month after implant loading and 3^rd months after implant loading respectively, the increase in the mean radiographic marginal bone height from the time of surgery to the 3^rd month after loading was found to be statistically significant (t= 10.81, p<0.0001). The mean radiographic bone density for study group was 90.16 ± 2.01, 96.27 ± 1.98, 101.36 ± 2.33 and 108.27 ± 2.13 at immediate postoperative, 3^rd month of implant placement, 1^st month after implant loading and 3^rd month after implant loading respectively, the increase in the mean radiographic bone density from the time of the surgery to the 3rd month after loading was found to be statistically significant (t= 43.80, p<0.0001). Conclusion: using connective tissue graft to cover immediate placed dental implants provided clinical and radiographic improvement with no side effect on the healing process.

Keywords:
atraumatic tooth extraction connective tissue graft immediate placed implant

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