The Effect of Bone Grafts on Facial Gingival Profile in Maxillary Anterior Single Tooth Replacement

Thirty subjects who are at least 18 years old with a failing upper front tooth seeking for
implant treatment will be recruited at Loma Linda University School of Dentistry (LLUSD),
where the consent will also take place. The subjects will be randomly divided into 3 groups.
The subjects will receive immediate implant placement and provisionalization (IIPP) in
conjunction with connective tissue graft (CTG) with (Group I) or without (Group II) bone
graft in the extraction socket; and with bone graft in extraction socket and at the facial
aspect of failing tooth (Group III). Clinical, radiographic and model assessments will be
performed at different time intervals (pre-treatment to 12 months after implant placement)
and statistically analyzed (α = 0.05) to evaluate peri-implant tissue response and facial
gingival profile of the implants. Complications, if any, will also be recorded and
appropriately addressed.

Inclusion Criteria:

1. Patients must be 18 years of age or older, are no longer growing and able to read and
sign an informed consent.

2. Good oral hygiene.

3. A single failing maxillary anterior tooth (#6-11) with the presence of healthy
adjacent teeth.

4. Adequate bone volume to accommodate an implant with minimum dimensions of 3.6 mm
diameter and 10.0 mm length.

5. Presence of opposing dentition (natural teeth, fixed or removable prostheses)

6. Healthy soft tissue at the future implant site.

Exclusion Criteria:

1. A medical history that would complicate the outcome of study such as alcohol or drug
dependency, poor health ,uncontrolled diabetes, immunodeficiency diseases, taking any
medication that may cause gingival over growth or any other medical, physical or
psychological reason that might affect the surgical procedure or the subsequent
prosthodontic treatment and required follow-up examinations.

2. Dental history of bruxism, parafunction habit, and/or lack of stable posterior
occlusion

3. Smoker.

4. History of head and neck radiation.

5. Soft tissue defect (inflammation, tissue cleft, unhealthy tissue) around a future
implant site.

6. Inability to achieve primary implant stability following immediate implant placement.