The effect of immediate implant placement on alveolar ridge preservation compared to spontaneous healing after tooth extraction: Soft tissue findings from a randomized controlled clinical trial

Abstract

Aim: To compare soft tissue dimensional changes and relative differences in soft and hard tissue volumes 4 months after single-tooth extraction and three different treatment modalities: spontaneous healing (SH) and alveolar ridge preservation by means of a deproteinized bovine bone mineral and a collagen matrix, with (IMPL/DBBM/CM) or without (DBBM/CM) immediate implant placement. Materials and Methods: STL files from study casts obtained at baseline and after 4 months were matched to calculate buccal soft tissue linear and volumetric changes. DICOM files from CBCTs were superimposed to STL files allowing the evaluation of soft tissue thickness at baseline and 4 months. Results: Mean horizontal reduction accounted for 1.46 ± 0.20 (SH), 0.85 ± 0.38 (DBBM-CM) and 0.84 ± 0.30 IMPL/DBBM-CM, with no statistical differences. Soft tissue thickness had a significant mean increase of 0.95 for SH group, compared to a non-significant mean decrease for DBBM-CM (0.20) and IMPL/DBBM-CM groups (0.07). Conclusion: A preservation technique with DBBM-CM, with or without immediate implant placement, did not reduce the horizontal linear and volumetric changes at the buccal soft tissue profile significantly at 4 months after tooth extraction when compared to spontaneous healing. This is due to a significant increase in soft tissue thickness in spontaneously healing sites.

Volumetric changes at implant sites: A systematic appraisal of traditional methods and optical scanning‐based digital technologies

“…Thirty‐two of the included studies (Basler et al, 2018; Benic et al, 2017; Bertl et al, 2017; Bittner et al, 2020; Borges et al, 2020; Cabanes‐Gumbau et al, 2019; Canullo et al, 2018; Clementini et al, 2020; De Bruyckere et al, 2020; Eeckhout et al, 2020; Fischer et al, 2019; Friberg & Jemt, 2012; Galarraga‐Vinueza et al, 2020; Hinze et al, 2018; Hosseini et al, 2020; Huber et al, 2018; Jiang et al, 2020; Papi et al, 2020; Parvini et al, 2020; Rojo et al, 2018, 2020; Sanz Martin et al, 2016; Sanz‐Martin et al, 2019; Sapata et al, 2018; Schneider et al, 2011; Thoma et al, 2020; Tian et al, 2019; van Nimwegen et al, 2018; Wang et al, 2019; Wei et al, 2019; Wittneben et al, 2016; Zeltner et al, 2017) assessed volumetric changes with optical scanning‐based digital technologies. Among them, four studies also assessed mucosal thickness (MT) changes with transgingival piercing methods (Hosseini et al, 2020; Huber et al, 2018; Papi et al, 2020; Thoma et al, 2020).…”

“…Twenty‐one studies (Basler et al, 2018; Benic et al, 2017; Bittner et al, 2020; Canullo et al, 2018; Clementini et al, 2020; De Bruyckere et al, 2020; Eeckhout et al, 2020; Fischer et al, 2019; Friberg & Jemt, 2012; Hinze et al, 2018; Hosseini et al, 2020; Huber et al, 2018; Sanz Martin et al, 2016; Sanz‐Martin et al, 2019; Sapata et al, 2018; Schneider et al, 2011; Thoma et al, 2020; van Nimwegen et al, 2018; Wang et al, 2019; Wittneben et al, 2016; Zeltner et al, 2017) reported generating 3D digital models from constructed dental casts obtained with different impression materials (including silicone, alginate, polyether, and polyvinyl siloxane) with the use of desktop 3D optical scanners (indirect technique). The other eleven studies (Bertl et al, 2017; Borges et al, 2020; Cabanes‐Gumbau et al, 2019; Galarraga‐Vinueza et al, 2020; Jiang et al, 2020; Papi et al, 2020; Parvini et al, 2020; Rojo et al, 2018, 2020; Tian et al, 2019; Wei et al, 2019) had obtained the 3D digital models with the use of intra‐oral scanners (direct technique).…”

“…Among them, six studies reported that a short‐span area was scanned (Galarraga‐Vinueza et al, 2020; Parvini et al, 2020; Rojo et al, 2018, 2020; Tian et al, 2019; Wei et al, 2019), while other articles did not provide information regarding the size of the scanned area. The method of digital model superimposition was automated (using an algorithm of the software) in fourteen studies (De Bruyckere et al, 2020; Eeckhout et al, 2020; Fischer et al, 2019; Hinze et al, 2018; Huber et al, 2018; Sanz Martin et al, 2016; Sanz‐Martin et al, 2019; Schneider et al, 2011; Thoma et al, 2020; Tian et al, 2019; van Nimwegen et al, 2018; Wang et al, 2019; Wei et al, 2019; Zeltner et al, 2017), and ‘hybrid’/semi‐automated (by selecting reproducible points prior to the algorithm or by using a semiautomatic algorithm first followed by manual alignment) in eleven studies (Basler et al, 2018; Bertl et al, 2017; Borges et al, 2020; Clementini et al, 2020; Galarraga‐Vinueza et al, 2020; Jiang et al, 2020; Papi et al, 2020; Parvini et al, 2020; Rojo et al, 2018, 2020; Sapata et al, 2018), with the remaining articles that did not specify this aspect. Three studies reported the amount of range of errors/tolerance between the two STL files during the superimposition (Bertl et al, 2017; Tian et al, 2019; Wei et al, 2019).…”

“…Table 1 includes the study design, intervention, types of impression materials, casts, digital scanners, and the utilized software for generating and analysing the 3D digital models. Twelve studies reported that the examiner was calibrated in terms of reproducibility of the volumetric analysis 3D measurements (Borges et al, 2020; Clementini et al, 2020; Fischer et al, 2019; Galarraga‐Vinueza et al, 2020; Hinze et al, 2018; Papi et al, 2020; Parvini et al, 2020; Sanz Martin et al, 2016; Sanz‐Martin et al, 2019; Sapata et al, 2018; van Nimwegen et al, 2018; Wang et al, 2019). In particular, in one study the calibration included performing all the measurements twice with an interval of 1 week (Sapata et al, 2018), while in another study the examiner had to repeat the measurements three times every other week on five randomly chosen participants (Wang et al, 2019).…”

“…The coefficient of reproducibility was reported in six studies, ranging from 0.8 to 0.93 (Borges et al, 2020; Papi et al, 2020; Parvini et al, 2020; Sapata et al, 2018; van Nimwegen et al, 2018; Wang et al, 2019; Table 1). Additionally, in ten studies, the operator who had performed the volumetric analysis had been blinded to the interventions (Borges et al, 2020; Clementini et al, 2020; Fischer et al, 2019; Rojo et al, 2018, 2020; Sanz Martin et al, 2016; Sapata et al, 2018; Thoma et al, 2020; Wang et al, 2019; Zeltner et al, 2017). All the included studies reported the software used for the volumetric analysis, with SMOP software (Swissmeda AG) being the most utilized (14 articles) (Basler et al, 2018; Benic et al, 2017; Clementini et al, 2020; De Bruyckere et al, 2020; Eeckhout et al, 2020; Fischer et al, 2019; Hinze et al, 2018; Huber et al, 2018; Sanz Martin et al, 2016; Sanz‐Martin et al, 2019; Sapata et al, 2018; Thoma et al, 2020; van Nimwegen et al, 2018; Zeltner et al, 2017), followed by Geomagic (3D systems) in eight studies (Borges et al, 2020; Jiang et al, 2020; Papi et al, 2020; Rojo et al, 2018, 2020; Tian et al, 2019; Wang et al, 2019; Wei et al, 2019) (Table 1).…”