Immediate Implant Placement With or Without Buccal Bone Dehiscence

Study Overview
=================
Brief Summary
-----------------
Immediate implant placement has been advantageous in terms of reduced treatment time and fewer surgical interventions. Given the fact that the level of buccal bone acts as a major prognostic factor for IIP, the indications for immediate implant placement were suggested to be limited to intact alveolar sockets.In recent years, many attempts have been performed to compensate for the alveolar ridge resorption in immediate implant placement in compromised sockets. The clinical outcomes of IIP with guided tissue regeneration and connective tissue grafting using papilla preservation technique in compromised extraction sockets has not been previously reported.

Official Title
-----------------
Clinical, Radiographic and Aesthetic Evaluation of Immediate Implant Placement With or Without Buccal Bone Dehiscence in the Anterior Maxilla

Conditions
-----------------
Dental Implant Failed

Intervention / Treatment
-----------------
* Procedure: flap elevation and guided bone regeneration
* Procedure: gap filling
* Procedure: connective tissue graft


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: patients with anterior failing teeth (from cainine to cainine) with the presence of neighbouring teeth sufficient bone volume to achieve primary stability at implant insertion Exclusion Criteria: with uncontrolled periodontitis heavy smoker (>10 cigarettes/day) unwilling to sign the informed consent

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| group1<br>socket with intact buccal bone plate | Procedure: gap filling<br>* to use biomaterials to fill the jumping gap<br>Procedure: connective tissue graft<br>* to change the soft tissue phenotype by connective tissue graft<br>|
| group 2<br>socket with damaged buccal bone plate | Procedure: flap elevation and guided bone regeneration<br>* to rebuild the alveolar ridge convexity<br>Procedure: gap filling<br>* to use biomaterials to fill the jumping gap<br>Procedure: connective tissue graft<br>* to change the soft tissue phenotype by connective tissue graft<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| mucosa recession | The height of the crown was measured by a peridontal probe in mid-facial aspect. The difference of the height of the crown over time was calculated as mucosa recession | baseline to 1-year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| probing depth | peri-implant probing depth detected by periodontal probe examined by a peridontal probe at six sites around the crown | baseline to 1-year | 
| bleeding on probing | percentage of sites with bleeding on probing examined by a peridontal probe at six sites around the crown | baseline to 1-year | 
| Pink Esthetic Score (0-14) | Seven parameters were assessed:mesial papilla, distal papilla, soft tissue level, soft tissue contour, alveolar process deficiency, soft tissue color, and soft tissue texture. Each parameter was scored as 2,1,0. | baseline to 1-year | 
| thickness of buccal bone plate | the distance between the implant's facial contour and the outside surface of the buccal bone measured by cone beam computor tomograph. | baseline to 1-year |