José Luis Calvo-Guirado1, Jose Antonio Benítez-García2, José Eduardo Maté Sánchez de Val3, Carlos Pérez-Albacete Martínez3, Sergio Alexandre Gehrke4, Rafael Delgado-Ruiz5, Ofer Moses6. 1. Full Professor of Oral and Implant Surgery, Director of International Dentistry Research Cathedra, Faculty of Oral Sciences, UCAM - Catholic University of Murcia, Murcia, Spain. Electronic address: jlcalvo@ucam.edu. 2. PhD Student of International Dentistry Research Cathedra, Faculty of Oral Sciences, UCAM - Catholic University of Murcia, Murcia, Spain. 3. Professor of Oral and Implant Surgery, Faculty of Oral Sciences, UCAM - Catholic University of Murcia, Murcia, Spain. 4. Professor, Director of Biotecnos Research Center - Tecnología e Ciencia Ltda. Montevideo, Uruguay, Director of Biotechnology Cathedra, UCAM - Catholic University of Murcia, Murcia, Spain. 5. Associate Professor in Prosthodontic, School of Dental Medicine, Stony Brook University of New York, USA. 6. Professor of Department of Periodontology and Dental Implantology, School of Dental Medicine, Tel Aviv University, Israel.
Abstract
OBJECTIVE: The aim of this study was to evaluate the influence of the location and length of root pieces on buccal peri-implant bone width and socket preservation in socket shield technique. MATERIAL AND METHODS: Forty-eight dental implants (24 narrow and 24 regular platform internal hex implants) were placed in six dogs. The clinical crowns of teeth P2, P3, P4 and M1 were detached horizontally and removed from the underlying roots. Then the mesial root of each tooth was extracted and the distal root was degraded using a high-speed hand-piece with round bur, creating a concave shell of dentin cementum and periodontal ligament (PDL) connected to the buccal aspect of the socket. Remaining root fragments of different lengths were created: coronal (1/3); middle and coronal (2/3); full length (3/3). These were positioned all around the bone crest. Implants were placed at the center of the root sockets, 1-3mm deeper than the original root apex. RFA and histological evaluations were made at 4 and 12 weeks. Data underwent statistical analysis (p<0.05). RESULTS: All 48 implants osseointegrated satisfactorily. On both buccal and lingual sides, the coronal (1/3) radicular fragment was attached to the buccal bone plate by physiologic periodontal ligament with less crestal bone resorption compared with middle (2/3) and whole root (3/3) groups for narrow and standard implants. CONCLUSIONS: Within the limitations of this study, the results demonstrate that a small piece of root in the coronal part of the alveolus can protect the buccal, mesial and distal bone crest following the immediate placement of NeO narrow or NeO Standard Internal Hex implants. The thickness of peri-implant bone and the remaining root fragment together will provide a total thickness of >2mm. The technique would appear to be highly predictable, maintaining bone volume and reducing the risk of crestal bone resorption.
OBJECTIVE: The aim of this study was to evaluate the influence of the location and length of root pieces on buccal peri-implant bone width and socket preservation in socket shield technique. MATERIAL AND METHODS: Forty-eight dental implants (24 narrow and 24 regular platform internal hex implants) were placed in six dogs. The clinical crowns of teeth P2, P3, P4 and M1 were detached horizontally and removed from the underlying roots. Then the mesial root of each tooth was extracted and the distal root was degraded using a high-speed hand-piece with round bur, creating a concave shell of dentin cementum and periodontal ligament (PDL) connected to the buccal aspect of the socket. Remaining root fragments of different lengths were created: coronal (1/3); middle and coronal (2/3); full length (3/3). These were positioned all around the bone crest. Implants were placed at the center of the root sockets, 1-3mm deeper than the original root apex. RFA and histological evaluations were made at 4 and 12 weeks. Data underwent statistical analysis (p<0.05). RESULTS: All 48 implants osseointegrated satisfactorily. On both buccal and lingual sides, the coronal (1/3) radicular fragment was attached to the buccal bone plate by physiologic periodontal ligament with less crestal bone resorption compared with middle (2/3) and whole root (3/3) groups for narrow and standard implants. CONCLUSIONS: Within the limitations of this study, the results demonstrate that a small piece of root in the coronal part of the alveolus can protect the buccal, mesial and distal bone crest following the immediate placement of NeO narrow or NeO Standard Internal Hex implants. The thickness of peri-implant bone and the remaining root fragment together will provide a total thickness of >2mm. The technique would appear to be highly predictable, maintaining bone volume and reducing the risk of crestal bone resorption.