Preservation of Peri-implant Hard Tissues Following Immediate Postextraction Implant Placement. Part I: Radiologic Evaluation.

Cardaropoli D, Tamagnone L, Roffredo A, De Maria A, Gaveglio L. Int J Periodontics Restorative Dent. 2019 Sep/Oct;39(5):633-641.

This study describes the immediate placement of dental implants in post extraction sockets for preservation of the alveolar ridge dimensions.

Methods: 20 patients requiring single tooth extractions were enrolled in the study. Following extraction, granulation tissue was removed and the implant bed was prepared. Before implant placement, a specifically designed bone plugger was inserted to accurately graft the peri-implant gaps using small cerabone® granules. The implant was installed, Emdogain® was applied on top of the graft and a provisional screw-retained abutment was placed. Finally, the definitive crown was delivered three months later. Marginal bone level (MBL) – and ridge width changes were evaluated using intraoral radiographs and CBCT images respectively, which were taken at implant placement (T0) and 12 months post-loading (T1).


  • Uneventful healing at all treated sites
  • Mean MBL was 2.70 ± 1.19 mm at T0 and 2.28 ± 1.34 mm at T1 (P < 0.05)
  • Ridge width changes (T0 – T1) were as follows: 0.59 ± 0.47 mm at the crest, 0.49 ± 0.36 mm 3 mm below the crest and 0.43 ± 0.32 mm 6 mm below the crest
  • Preservation of the horizontal ridge dimensions (T0 – T1) were accordingly: 93.18% ± 5.33% at the crest, 94.37% ± 4.41% 3 mm below the crest, 95.13% ± 3.66% 6 mm below the crest
  • Ridge width changes were independent of the buccal plate thickness

Conclusion: The authors concluded that immediate implant placement with immediate restoration supports the preservation of the alveolar ridge volume.  Marginal bone level was demonstrated to be stable over the observation period of 12 months. An accurate grafting as presented with cerabone® of the peri-implant bone gaps was considered crucial to minimize marginal bone level changes.

Daniele Cardaropoli