A prospective cohort study of immediate implant placement into posterior compromised sockets with or without primary wound closure of reactive soft tissue.

Abstract

Conventional wisdom states that reactive soft tissue consisting of granulation tissue and long junctional epithelium in compromised sites should be curetted completely, while others approve of its preservation in implant surgeries. To evaluate the presence of reactive soft tissue as wound closure for immediate implantation in posterior compromised sockets. Thirty-three implants were included in this study: (a) experimental group (EG), the reactive soft tissue was raised as the primary wound closure for the implant; (b) control group (CG), the reactive soft tissue was also elevated but failed to cover the site. Implants were inserted immediately after the tooth extraction. The bone dimensional changes were observed instantly after surgery (T1) and 6 months later (T2) by cone beam computed tomography. Soft tissue alterations were evaluated before tooth extraction (T0), at prosthesis delivery and at 1-year follow-up (T3). Measurements of marginal bone level (MBL) was obtained at the time of prosthesis placement and at T3. In all, 100% implant survival was reported during the study period. The buccal bone height and width of keratinized mucosa decreased less in the EG compared to the CG. At the 1-year follow-up, MBL and soft tissue changes were not significantly different between the two groups. Within the limitations of this study, the presence of reactive soft tissue as primary closure may contribute to hard-soft tissue augmentation during immediate implants into posterior compromised sockets.