Nada Mohamed Sherif , Hala Kamal Abdel Gaber And Ahmed Elsayed Hamed Amr,

ABSTRACT


Aim: 1ry Objective: To Compare Two Different Approaches Applied In Conjunction With Immediately Placed Dental Implant Regarding The Enhancement Of The Soft Tissue Profile Around The Implant. 1st Approach Is The Placement Of The Particulate Bone Graft In A Surgically Created Sub-periosteal Pouch Adjoining The Buccal Plate Around The Implant, While The 2nd Approach Is The Placement Of Connective Tissue Graft In Surgically Created Sub-periosteal Pouch Adjoining The Buccal Plate Around The Implant. 2ry Objective: To Compare The Formerly Described Approaches Regarding The Effect On The Labial Alveolar Bone Around The Immediate Dental Implant. Subjects And Methods: Sixteen Extraction Sockets In 16 Patients Were Included In This Study. Eight Of Them (test Group), Were Treated With Placing A Bone Graft Overlying The Buccal Bone Plate In A Surgically Created Pouch, And Eight Of Them (control Group) Were Treated With Placing A Subepithelial Connective Tissue Graft Overlying The Buccal Plate In A Surgically Created Pouch. Result: 1- Keratinized Gingival Thickness, In Group (1), The Mean Value Increased From Baseline To 9 Months. Paired T Test Revealed That The Difference Was Statistically Significant (p=0.048). In Group (2), The Mean Value Increased From Baseline To 9 Months. Paired T Test Revealed That The Difference Was Extremely Statistically Significant (p=0.00). Regarding The Percent Of Change In Group (1) In Comparison To A Percent Of Change In Group (2), Mann Whitney U Test Revealed That The Difference Was Not Statistically Significant (p=0.44). 2- Keratinized Gingiva Width, In Group (1), The Mean Value Increased At 9 Months In Comparison To Baseline. Paired T Test Revealed That The Difference Was Not Statistically Significant (p=0.064). In Group (2), The Mean Value Decreased At 9 Months In Comparison To Baseline. Paired T Test Revealed That The Difference Was Statistically Significant (p=0.02). 3- CBCT (measuring The Bucco-lingual Ridge Width): In Group (1), The Mean Value Decreased After Treatment. Paired T Test Revealed That The Difference Was Not Statistically Significant (p=0.268). In Group (2), The Mean Value Increased After Treatment. Paired T Test Revealed That The Difference Was Statistically Significant (p=0.013). And Regarding The Percent Of Change After Treatment, A Decrease Was Noted In Group (1), While An Increase Was Noted In Group (2). Mann Whitney U Test, Revealed That The Difference Was Statistically Significant (p=0.02). 4- Marginal Bone Level: Regarding The Percent Of Change Between Two Groups From Base-line To 9 Months, A Mean Percent Of Change Increase Was Recorded In Group (1), While A Mean Percent Of Change Decrease Was Noted In Group (2). Mann Whitney U Test, Revealed That The Difference Was Statistically Significant (p=0.01). Conclusion: Particulate Xenograft Used In Labial Sub-periosteal Pouch Around Immediate Implant Enhances The Gingival Biotype And Keratinized Gingival Width Thus Can Optimize The Soft Tissue Profile And Final Esthetics. Moreover, It Helps In Minimizing Crestal Bone Loss But Has No Remarkable Effect On Ridge Bucco-lingual Bone Changes.