Time of Implant Placement in the Esthetic Zone: Does it affect the Thickness of the Labial Bone?

Abstract

Purpose: to evaluate the labial bone thickness (LBT) in the esthetic zone of the maxilla after insertion of dental implants: immediately, 4-6 weeks, and 3 months after tooth extraction, by using cone beam computed tomography (CBCT). Patients and methods: Fifteen cases, who had single non-restorable upper anterior tooth or an extracted tooth not exceeding 3 months, were involved in the study. The patients were divided equally into three groups. In group 1, implants were placed immediately after tooth extraction. In group 2, implants were inserted 4-6 weeks after extraction. In group 3, implants were inserted 3 months following tooth extraction. All implants were covered by bovine bone graft substitute (BBGS) and platelet rich fibrin (PRF) membrane. The LBT was measured immediately after implant insertion, six and 12 months of surgery by using (CBCT). The patients were examined clinically by assessing probing depth (PD), sulcus bleeding index (SBI), pink esthetic score (PES), and visual analogue score (VAS). Results: Successful osseointegration was observed in all patients, both clinically and radiographically. There was insignificant difference in the labial bone thickness between the 3 groups; however, the amount of bone resorption was considered significant only in group 1, at the implant shoulder, during the first interval of the follow up (immediate to six months postoperative). Conclusion: Preservation of LBT at the labial surface of the dental implants in the esthetic zone of the maxilla appears to be independent on the time of implant insertion after tooth extraction. It was possible to create and preserve a stable layer of labial bone over implant surface, by the application of BBGS and PRF membrane.