Correction of Buccal Dehiscence at the Time of Implant Placement Without Barrier Membranes: A Retrospective Cone Beam Computed Tomographic Study

Purpose: To assess the clinical and tomographic findings of a grafting approach without barrier membranes to treat peri-implant buccal bone dehiscences at the time of implant placement. Materials and Methods: This retrospective study was conducted on all patients who needed implant placement with buccal bone grafting and were treated consecutively between March 2007 and June 2010. Two different implant systems were used (PSI, Globtek; XiVE Plus, Dentsply/Friadent). All sites had thick soft tissue (> 2 mm). All bone dehiscences were completely grafted with biphasic calcium phosphate and covered only by a soft tissue flap. Cone beam computed tomographic images were used to assess vertical buccal bone loss by measuring the distance between the implant platform and the first buccal bone contact with the implant body. Statistical analysis (Mann-Whitney test) was carried out to compare the outcomes from the two different implant systems analyzed. Results: Forty-one subjects (18 men, 23 women; mean age 57.3 ± 10.4 years) were selected and received 60 implants (52 delayed and 8 immediate placement). Mean follow-up was 26 months (range, 18 to 39 months). All 8 immediate implants and 33 of the 52 delayed implants presented buccal bone loss from 0 to 0.5 mm. Only two delayed sites presented buccal bone loss over 2 mm. No significant differences were seen between the implant systems. The study implant cumulative success rate was 100% (mean follow-up, 26 months). Conclusion: Predictable outcomes can be obtained by grafting buccal bone dehiscence areas without barrier membranes in sites with a minimum soft tissue thickness greater than 2 mm.