This study aimed to assess the treatment outcome of immediate reconstruction of large osseous defects resulting from removal of a single tooth in the aesthetic zone. All 45 defects had an unfavourable osseous–gingival relationship and a vertical bone loss of >5 mm. The hard tissues were immediately reconstructed after removal the tooth with a 1:2 mixture of Bio-Oss ® and autologous tuberosity bone. The soft tissues were reconstructed with either a Bio-Gide ® membrane, a connective tissue graft or a full thickness palatal mucosa graft ( n = 15 per group). Implants were inserted after 3 months. Patients’ acceptance, complications and postoperative morbidity of the procedure were prospectively evaluated by standardized clinical and radiographic examinations up to 12 months after the augmentation procedure as well as that the patients had to complete a questionnaire on subjective complaints related to the procedure. All hard–soft tissue scenarios resulted in a sufficient bone volume for the insertion of implants and a favorable aesthetic outcome. The gingival mid-buccal aesthetics before and 1 year after treatment were significantly in favour of the full thickness palatal mucosa graft which resulted in a gain in gingival contour of 0.5 ± 0.8 mm. The Bio-Gide ® membrane and connective tissue graft procedures resulted in a decrease in gingival contour of 1.2 ± 1.6 mm. Of the procedures evaluated, the combination of reconstruction of the bony defect with a 1:2 mixture of Bio-Oss ® and autologous tuberosity bone in combination with reconstruction of the soft tissues with a full-thickness palatal mucosa graft was the most predictable immediate reconstruction procedure of a large osseous defect after removal of a tooth. This treatment protocol is in favor for ridge preservation after removal of a tooth.
Ridge preservation in case of large osseous defects resulting from single tooth removal to prepare for endosseous implant insertion
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