Ridge alterations following implant placement in fresh extraction sockets: an experimental study in the dog

Abstract Objective: To study dimensional alterations of the alveolar ridge that occurred following implant placement in fresh extraction sockets. Material and Methods: Five beagle dogs were included in the study. In both quadrants of the mandible, incisions were made in the crevice region of the third and fourth pre‐molars. Buccal and minute lingual full‐thickness flaps were elevated. The mesial root of the four pre‐molars root was filled and the teeth were hemi‐sected. Following flap elevation in 3 P 3 and 4 P 4 regions, the distal roots were removed. In the right jaw quadrants, implants with a sand blasted and acid etched (SLA) surface were placed in the fresh extraction sockets, while in the left jaws the corresponding sockets were left for spontaneous healing. The mesial roots were retained as surgical control teeth. After 3 months, the animals were examined clinically, sacrificed and tissue blocks containing the implant sites, the adjacent tooth sites (mesial root) and the edentulous socket sites were dissected, prepared for ground sectioning and examined in the microscope. Results: At implant sites, the level of bone‐to‐implant contact (BC) was located 2.6±0.4 mm (buccal aspect) and 0.2±0.5 mm (lingual aspect) apical of the SLA level. At the edentulous sites, the mean vertical distance (V) between the marginal termination of the buccal and lingual bone walls was 2.2±0.9 mm. At the surgically treated tooth sites, the mean amount of attachment loss was 0.5±0.5 mm (buccal) and 0.2±0.3 mm (lingual). Conclusions: Marked dimensional alterations had occurred in the edentulous ridge after 3 months of healing following the extraction of the distal root of mandibular pre‐molars. The placement of an implant in the fresh extraction site obviously failed to prevent the re‐modelling that occurred in the walls of the socket. The resulting height of the buccal and lingual walls at 3 months was similar at implants and edentulous sites and vertical bone loss was more pronounced at the buccal than at the lingual aspect of the ridge. It is suggested that the resorption of the socket walls that occurs following tooth removal must be considered in conjunction with implant placement in fresh extraction sockets.