Dental Implants Placed in Extraction Sites Grafted With Different Bone Substitutes: Radiographic Evaluation at 24 Months

Background: Reduction of alveolar height and width after tooth extraction may provide some problems in implant placement, especially in the anterior maxilla for esthetic reasons. Different graft materials have been advocated to prevent bone-volume reduction. The aim of this study was to evaluate radiographic parameters of implants positioned in grafted alveoli with three different biomaterials: magnesium-enriched hydroxyapatite (MHA), calcium sulfate (CS), and heterologous porcine bone (PB). Methods: In 15 patients, 45 fresh extraction sockets with three bone walls were selected. Fifteen sockets received MHA, 15 sockets received CS, and 15 sockets received corticocancellous PB as a graft material. Three months after bone filling, titanium dental implants were placed in grafted sites. Three months after implant placement, temporary restoration was performed. Follow-up examinations were conducted, and intraoral digital radiographs were taken at baseline and 12 and 24 months after implant placement to evaluate the marginal bone level in each patient. Comparisons for marginal bone loss over time between groups were performed by the Student two-tailed t test. Results: At the 24-month follow-up, a survival rate of 100% was reported for all implants. For the MHA group, a mean mesial bone loss of -0.21 +/- 0.08 mm and a mean distal bone loss of -0.22 +/- 0.09 mm (mean bone loss: 0.21 +/- 0.09 mm) were reported; for the CS group, a mesial bone loss of -0.14 +/- 0.07 mm and a distal bone loss of -0.12 +/- 0.11 mm (mean bone loss: -0.13 +/- 0.09 mm) were measured; for the PB group, a mean mesial bone loss of -0.15 +/- 0.10 mm and a mean distal bone loss of -0.16 +/- 0.06 mm (mean bone loss: -0.16 +/- 0.08 mm) were reported. No statistically significant differences were reported among groups (P>0.05). Conclusion: At the 24-month follow-up, the present study showed that placement of implants in grafted sockets was not influenced by the three different biomaterials because they did not negatively impact the clinical outcome. J Periodontol 2009,80:1616-1621.