Buccal Plate Preservation with Immediate Implant Placement and Provisionalization: 5-Year Follow-Up Outcomes.

Abstract

Despite socket preservation and/or immediate implant placement, resorption of the buccal plate after dental extraction continues to pose esthetic challenges to clinicians. Buccal plate preservation (BPP) is a technique that has been recently proposed with an aim to reduce the incidence of such resorption. This study was conducted to assess the long-term efficacy of BPP in maintaining the thickness of the buccal cortical plate after immediate implant insertion and provisionalization. Ten consecutive patients were included in this study. Each patient underwent extraction of a non-restorable tooth, BPPPBPP, single immediate implant placement and immediate provisionalization. Cone beam CT scans were taken 3months after surgery (T1) and 5years after surgery (T2) to evaluate the effectiveness and longevity of the BPPPBPP technique in maintaining the augmented bone width. Two distinct measurements were taken for bone evaluation: (a) R1: 1mm apical to the implant platform and (b) R2: 5mm apical to the implant platform. The long axis of the implant was used as a fixed reference. Statistical test analysis was conducted using the SPSS software. Student's t test was used to assess statistical significance, and a p value of <0.05 was considered significant. There were six females and four males in the study. The mean age of the sample was 37.6years (range 23-64years). At T1, the mean bone thickness of the buccal plate was found to be 2.36mm at R1 (range: 1.9-3.1), and 2.23 at R2 (range: 1.9-3). At the T2 interval, the mean thickness of the plate was 2.28mm at R1 (range: 1.7-3) and 2.18 at R2 (range: 1.9-3). The differences in these mean values were not statistically significant. BPPPBPP is an effective means for augmentation and maintenance of the buccal cortical plate around an immediately placed and provisionalized dental implant. It is a viable alternative to socket preservation with the added benefit that it allows for immediate implant placement.