Vestibular socket therapy with immediate implant placement for managing compromised fresh extraction sockets: A prospective single-arm clinical study.

Abstract

Purpose: To assess hard and soft tissues regenerated around immediate implants placed in compromised fresh extraction sockets using vestibular socket therapy 2 years postoperatively.

Materials and methods: Twenty-seven compromised fresh extraction sockets were managed using vestibular socket therapy and immediate implant placement. After immediate implant placement, a cortical bone shield was stabilised through a vestibular incision. The socket defect was filled with particulate bone graft. Labial plate thickness and bone height were evaluated 1 and 2 years postoperatively using CBCT. The pink aesthetic score and probing depth were recorded after 6 months, 1 year and 2 years. A Friedman test was used to study changes in the reported outcomes over time, with the level of statistical significance set at P ≤ 0.05.

Results: All implants recorded a 100.0% survival rate. A statistically significant increase in bone height (0.93 mm, P = 0.004) and apical (0.12 mm, P = 0.026), midfacial (1.26 mm, P < 0.001) and crestal (0.86 mm, P < 0.001) bone thickness was observed after 2 years. The changes in pink aesthetic score and probing depth were not significant: the pink aesthetic score was 12.48 ± 1.45 and the mean PD was 2.37 ± 0.79 mm mesially, 2.11 ± 0.70 mm facially, 2.07 ± 1.04 mm distally and 1.00 ± 0.00 mm palatally after 2 years.

Conclusion: Combining immediate implant placement with vestibular socket therapy to manage compromised fresh extraction sockets offers promising radiographic, aesthetic and periodontal results while minimising the treatment time and number of surgical procedures required.