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Purpose: This study assessed a novel treatment protocol for immediate implant placement in defective fresh extraction sockets. Materials and Methods: A single-arm clinical study was conducted including 12 fresh extraction sockets divided into two groups: those with intact and those with a deficient facial plate of bone. Hopeless teeth were atraumatically extracted, a vestibular access horizontal incision was made 3 to 4 mm apical to the mucogingival junction, a mucoperiosteal tunnel was created from the labial orifice of the socket, a slowly resorbing membrane shield was stabilized under the tunnel, implants were placed using a surgical guide, and a subepithelial connective tissue graft was harvested and secured over the membrane shield. Definitive restorations were delivered at 3 months postoperatively. Cone beam computed tomography (CBCT) scans were taken at baseline and after 6 and 13 months to measure facial bone thickness and height. Pink esthetic score (PES) was recorded at 6 and 13 months. Results: At 6 months, the mean ± SD facial bone thickness was 1.88 ± 0.73 mm for sockets with intact facial bone compared to 0.76 ± 0.42 at baseline and 2.34 ± 0.78 mm for sockets with deficient facial bone compared with 0 ± 0 at baseline, whereas at 13 months, the thickness was 1.84 ± 0.74 and 2.18 ± 0.73 mm, respectively. The facial bone crest coincided with the implant platform in sockets with an intact facial bone plate and those with a deficient facial bone plate at 6 months, whereas at 13 months, the distance for sockets with a deficient facial bone plate increased to 0.20 ± 0.13 mm. The mean PES at 6 and 13 months was 11.33 for both groups out of a maximum score of 14. Conclusion: The proposed technique provided a minimally invasive treatment with predictable esthetic outcome allowing immediate implant placement in sockets with intact and with deficient facial plates. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the clinical and radiographic outcome of dental implants immediately placed and loaded into fresh extraction sockets after 18 months. Materials and Methods: Twenty-seven patients, 15 women and 12 men, received a total of 160 implants; 150 were placed immediately after extraction. The sockets in the study had fully preserved walls, and 10 were placed in healed sites. Immediately after surgical procedure, all patients received the temporary prosthetic reconstruction in occlusion. Five months postsurgery, definitive metal-ceramic restorations were cemented on abutments. Follow-up visits were performed for the assessment of clinical parameters. Intraoral digital radiographic examinations were performed 3 and 18 months after implant placement. Results: Minor swelling of the gingival mucosa was observed, but no mucositis or flap dehiscence with suppuration were found. Mean marginal bone loss 1 year 18 months after immediate loading was 0.65 ± 0.58 mm to the mesial side and 0.84 ± 0.69 mm to the distal side in the maxilla and 1.13 ± 0.51 mm mesially and 1.24 ± 0.60 mm distally in the mandible. There was no difference between splinted and nonsplinted implants with respect to marginal bone loss. Discussion and Conclusion: Within the limits of this clinical study, the results indicate that immediate loading of implants placed in immediate extraction sites can be carried out successfully. [ABSTRACT FROM AUTHOR]