Debora Dias

BACKGROUND: It is well known that following tooth extraction the alveolar process undergoes marked changes, resulting in ridge reduction. Grafting of the gap between the implant shoulder and the buccal bone wall when placing immediate implants has been suggested to limit these changes. Nevertheless, other anatomical characteristics may play a role on socket healing. Therefore, the aim of the present study was to describe the anatomical predictors for a successful ridge preservation with immediate implant placement (IIP) at maxillary central incisor sites. METHODS: Twenty-five patients who had a single failing maxillary central incisor with an intact buccal wall and presence of the contralateral tooth were included in this retrospective cohort study. Following minimally invasive tooth extraction and IIP, the resulting buccal gap wall was measured and filled with deproteinized bovine bone mineral (DBBM). After 5.6±3.8 years in function, CBCT scans were obtained and assessed by a calibrated examiner. Linear and cross-sectional measurements were performed. Implant sites were compared to the contralateral tooth sites. A linear regression model was built with the reduction of the alveolar process area as the dependent variable. RESULTS: The cross-sectional area of the alveolar process was, on average, 85mm2 (±18.3) at the tooth sites and 65mm2 (±26.8) at the implant sites. Mean alveolar process reduction was -24.3% (±24.1). Anatomical predictors of the reduction in the alveolar process area were the thickness of the buccal bone at 3 mm from the crest, width of the alveolar process at the same level, tooth angulation in relation to the basal bone, and the size of the gap grafted with DBBM. CONCLUSIONS: Within the limitations of this study, the selection of a site with adequate anatomical features and proper implant planning are fundamental for successful ridge preservation associated with IIP.

Debora Dias, DDS, MSc, is currently a PhD candidate in Integrated Dentistry at the State University of Maringá (UEM) in Brazil, under the supervision of Dr. Mauricio Araújo. She is enrolled in a 12-month research program at the University of Pittsburgh, under the supervision of Drs. Andrea Ravidà and Martinna Bertolini. Dr. Dias has completed a 2-year Periodontics Residency Program and obtained her master’s degree at UEM. She is a member of the Perio/Implant Research Unit, headed by Dr. Araújo, where she has been working on different projects including socket healing and ridge preservation for immediate or late implant placement. She won the first prize of the ITI World Symposium 202ONE poster competition in Clinical Research – Surgery (2021). She is currently a member of the ITI – International Team for Implantology and ambassador of the National Osteology Group Brazil – Osteology Foundation.