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To Graft or Not? The Effect of Placing a Bone Replacement Graft with Immediate Implants

I had the pleasure to welcome Dr. Mariano Sanz, Professor in the Faculty of Odontology at the University Complutense in Madrid. our conversation was about whether or not to use a bone replacement graft in combination with immediate implants.

I hope you will find the interview informative and will share your feedback and questions with us at oasisdiscussions@cda-adc.ca

Chiraz Guessaier, CDA Oasis Manager

Highlights

The aim of the study was to assess the added value of using a bone replacement graft in combination with immediate implants in reducing the bone dimensional changes occurring in the residual ridge.

Material and methods

Randomized parallel controlled clinical trial to study the efficacy of grafting with demineralized bovine bone mineral with 10% collagen (DBBM-C) in the gap between the implant surface and the inner bone walls when the implants were immediately placed in the anterior maxilla. The changes between implant placement and 16 weeks later in the horizontal and vertical crestal bone changes in relation to the implant were evaluated through direct bone measurements using a periodontal probe. Mean changes were compared between the experimental and control sites using parametric statistics.

Results

A total of 86 implant sites in 86 subjects were included in the analysis (43 in the test group and 43 in the control group). The horizontal crest dimension underwent marked changes during healing mainly at the buccal aspect of the alveolar crest where this reduction amounted to 1.1 (29%) in the test group and 1.6 mm (38%) in the control group, being these statistically significant (P = 0.02). This outcome was even more pronounced at sites in the anterior maxilla and with thinner buccal bone plates.

Conclusions

In conclusion, the results from this clinical trial demonstrated that placing a DBBM-C bone replacement graft significantly reduced the horizontal bone resorptive changes occurring in the buccal bone after the immediate implantation in fresh extraction sockets.

Full Interview (10.59″)

 

3 comments

  1. Is there a commercial brand name for the DBBM-C that was used?

    • Good morning Timothy, Thank you for taking the time to leave a comment. I will forward your inquiry to the author and post his response when I receive it.
      Best regards,
      Chiraz Guessaier, CDA Oasis Manager

  2. I am curious as to whether or not the author established primary closure in all cases. Tarnow, in the International Journal of Periodontics and Restorative Dentistry (Volume 31, number 5, 2011) demonstrates ideal bony fill in the presence of a 4 mm gap and no bone grafting. In this case study, a thick buccal plate was present, and no primary closure was attempted.

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