Management of Buccal Gap and Resorption of Buccal Plate in Immediate Implant Placement: A Clinical Case Report

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Abstract

When a dental implant is placed into a fresh extraction socket, a space between the implant periphery and surrounding bone occurs. A gap can occur on any aspect of an immediately placed implant: Buccal, lingual or proximally. The objective of immediate implant placement is to provide an osseointegrated fixture suitable for an aesthetic and functional restoration. Bone fill in the gap between the implant and the peripheral bone is important. Surgical management of the buccal gap to obtain an optimal result is controversial and confusing with respect to the best techniques to achieve the following: Optimal bone fills in the gap, most coronal level of bone-to-implant contact, and the least amount of buccal bone loss and soft tissue recession. This clinical case report illustrates the management of the buccal gap and reducing buccal plate resorption when contemplating immediate implant placement.

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Most cited references 18

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The effect of the distance from the contact point to the crest of bone on the presence or absence of the interproximal dental papilla.

D Tarnow, P Thomas Fletcher, A Magner (1992)

This study was designed to determine whether the distance from the base of the contact area to the crest of bone could be correlated with the presence or absence of the interproximal papilla in humans. A total of 288 sites in 30 patients were examined. If a space was visible apical to the contact point, then the papilla was deemed missing; if tissue filled the embrasure space, the papilla was considered to be present. The results showed that when the measurement from the contact point to the crest of bone was 5 mm or less, the papilla was present almost 100% of the time. When the distance was 6 mm, the papilla was present 56% of the time, and when the distance was 7 mm or more, the papilla was present 27% of the time or less.

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The mucosal barrier following abutment dis/reconnection. An experimental study in dogs.

I Abrahamsson, T Berglundh, J Lindhe (1997)

In the present experiment, the effect on the marginal peri-implant tissues following repeated abutment removal and subsequent reconnection was studied. 5 beagle dogs were used. The mandibular premolars were extracted and 2 fixtures of the Brånemark System were installed, 1 in each mandibular quadrant. 3 months later, abutment connection was performed. A 6-month period of plaque control was initiated. Once a month during the plaque control period, the abutment of the right side (test) in each dog was disconnected, cleaned and reconnected to the failure. Thus, each test abutment was removed and reconnected altogether 5x during this period. The contralateral abutment remained undisturbed for 6 months and served as control. 1 month after the last reconnection, the animals were sacrificed and tissue samples, comprising the implant and the surrounding soft and hard peri-implant tissues, were obtained, decalcified, embedded in Epon and sectioned. The following landmarks were identified and used for linear measurements: PM (the marginal portion of the peri-implant mucosa), aJE (the level of the apical termination of the junctional epithelium), B (the marginal level of bone to implant contact), A/F (the abutment/fixture border). The findings indicate that the dis- and subsequent reconnections of the abutment component of the implant compromised the mucosal barrier and resulted in a more "apically" positioned zone of connective tissue. The additional marginal bone resorption observed at the test sites following abutment manipulation may be the result of tissue reactions initiated to establish a proper "biological width" of the mucosal-implant barrier.

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Dimension of the facial bone wall in the anterior maxilla: a cone-beam computed tomography study.

Josélio Araújo, Juliana Cristina Mesti, J Lindhe … (2011)

To determine the thickness of the facial bone wall in the anterior dentition of the maxilla and at different locations apical to the cemento-enamel junction (CEJ). Two-hundred and fifty subjects, aged between 17 and 66 years, with all maxillary front teeth present were included. Written informed consents were obtained. Cone-beam computed tomography scans were performed with the iCAT unit. This examination included all tooth and edentulous sites in the dentition. The images were acquired by means of the iCAT software and processed by a computer. Measurements of the (i) distance between the CEJ and the facial bone crest and (ii) the thickness of the facial bone wall were performed. The bone wall dimensions were assessed at three different positions in relation to the facial bone crest, i.e., at distances of 1, 3, and 5 mm apical to the crest. The measurements demonstrated that (i) the distance between the CEJ and the facial bone crest varied between 1.6 and 3 mm and (ii) the facial bone wall in most locations in all tooth sites examined was ≤1 mm thick and that close to 50% of sites had a bone wall thickness that was ≤0.5 mm. Most tooth sites in the anterior maxilla have a thin facial bone wall. Such a thin bone wall may undergo marked dimensional diminution following tooth extraction. This fact must be considered before tooth removal and the planning of rehabilitation in the anterior segment of the dentition in the maxilla. © 2011 John Wiley & Sons A/S.

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Author and article information

Journal

Journal ID (nlm-ta): J Int Oral Health

Journal ID (iso-abbrev): J Int Oral Health

Journal ID (publisher-id): JIOH

Title: Journal of International Oral Health : JIOH

Publisher: Dentmedpub Research and Printing Co (India )

ISSN (Print): 0976-7428

ISSN (Electronic): 0976-1799

Publication date (Print): 2015

Volume: 7

Issue: Suppl 1

Pages: 72-75

Affiliations

[1]Department of Periodontology and Implantology, College of Dental Sciences and Research Centre, Manipur, Ahmedabad, Gujarat, India

Author notes

Correspondence: Dr. Shah S. 92/A, Yogeshwarnagar Society, Anjali Cross Road, Bhattha, Paldi, Ahmedabad - 380 007, Gujarat, India. Phone: +91-9924083567, 079-26607716. Email: sheekha89@ 123456gmail.com

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Publisher ID: JIOH-7-72

PMC ID: 4516068

PubMed ID: 26225110

SO-VID: d97c1c79-7531-47f2-88e0-f5c9c1e35b69

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This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Management of Buccal Gap and Resorption of Buccal Plate in Immediate Implant Placement: A Clinical Case Report

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Most cited references 18

The effect of the distance from the contact point to the crest of bone on the presence or absence of the interproximal dental papilla.

The mucosal barrier following abutment dis/reconnection. An experimental study in dogs.

Dimension of the facial bone wall in the anterior maxilla: a cone-beam computed tomography study.

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