Immediate Implant Placement with Buccal Bone Augmentation in the Anterior Maxilla with Thin Buccal Plate: A One‐Year Follow‐Up Case Series

Abstract Purpose To evaluate the buccal bone thickness of immediate implant placement with buccal bone augmentation in patients with a thin buccal plate in the esthetic zone. Materials and methods Eighteen consecutive patients requiring a single tooth replacement in the anterior maxillary zone with a thin plate (<1 mm) were included and received immediate implant placement with narrow‐diameter implants. Patients received buccal bone augmentation (both internal and external socket bone grafting) with deproteinized bovine bone mineral (DBBM) and an absorbable membrane. The final restoration was delivered after 8 months. Cone‐beam CT scans were performed before surgery (CBCT0), immediately after surgery (CBCT1), at final restoration delivery (CBCT2), and at 1‐year follow‐up after the final restoration (CBCT3) to evaluate the buccal bone thickness and ridge width. A repeated measures ANOVA and Bonferroni correction for multiple comparisons were applied for statistical analysis of changes within different time points (α = 0.05). Results Fifteen of the 18 enrolled patients were available for analysis at the 1‐year follow‐up after final restoration. The mean buccal bone thickness at 2 mm apical to the implant‐abutment junction (IAJ‐2) were 3.59 mm (range: 3.04‐4.58 mm), 2.79 mm (range: 2.25‐3.78 mm), and 2.52 mm (range: 1.72‐3.36 mm), respectively, at CBCT1, CBCT2, and CBCT3. A statistical significance was observed for buccal bone thickness change between CBCT1 and CBCT2 at IAJ‐2 ( F = 17.948, p = 0.001). The net gains of the ridge width from CBCT0 to CBCT1, CBCT1 to CBCT2, and CBCT2 to CBCT3 were 1.08 mm, –0.94 mm and –0.04 mm at 4 mm apical to the cementum‐enamel junction, respectively. No statistical significance was observed for the change in ridge width from CBCT0 to CBCT3 ( F = 10.518, p = 1.000). Conclusions Simultaneous buccal bone augmentation may maintain a predictable buccal bone thickness for immediate implant placement in the maxillary anterior sites with a thin buccal plate (<1 mm) at 1‐year follow‐up after final restoration.