Me. Gher et al., BONE-GRAFTING AND GUIDED BONE REGENERATION FOR IMMEDIATE DENTAL IMPLANTS IN HUMANS, Journal of periodontology, 65(9), 1994, pp. 881-891
THIS STUDY EVALUATED BONE REGENERATION and osseointegration of hydroxy
apatite (HA) coated and titanium plasma sprayed (TPS) implants placed
in sockets immediately after extraction in 36 adults, mean age 55.2 ye
ars (range 26 to 81 years). Twelve TPS and 10 HA-coated implants in 20
patients were grafted with demineralized freeze-dried bone allograft
(DFDBA), covered with a barrier material, and the facial flap coronall
y positioned to attain primary closure (experimental). The remaining 1
1 TPS and 10 HA-coated implants were placed similarly, except that no
DFDBA was used (control). Osseous structures were measured at the init
ial placement and 6-month re-entry surgeries. At the 6-month re-entry,
all implants placed were clinically osseointegrated. Bone resorption
at the most coronal socket crest was -1.53 mm for the grafted group an
d -1.59 mm for the control group. Crestal bone apposition of 1.39 mm w
as noted at the most apical socket crest (ASC) for the grafted group,
whereas crestal resorption of -0.11 mm was noted in the ungrafted cont
rol group (P < 0.02). Bone fill from the base of the deepest osseous d
efect was 5.68 mm for the grafted group and 3.18 mm for the control gr
oup (P < 0.04). Complete resolution of osseous defects occurred at 15
of 22 sites in the grafted group and at 9 of 21 sites in the control g
roup. Clinical exposure of the barrier material and a subsequent infla
mmatory response at 27 of 43 sites, required removal of the material p
rior to the 6-month re-entry and was associated with significantly mor
e bone loss at the ASC sites (P < 0.01). There was no significant diff
erence for any of the parameters when comparing the TPS with the HA-co
ated implants.