Effect of autogenous tooth vs. autogenous bone grafts on periodontal phenotype around immediate implants: A randomized clinical trial.

BACKGROUND

Immediate implant placement can result in a horizontal defect between the implant and alveolar bone, potentially affecting osseointegration and esthetic outcomes. Grafting this space supports bone regeneration. This study compared the effectiveness of autogenous tooth-derived and autogenous bone grafts for horizontal gap augmentation in the maxillary anterior region.

METHODS

This parallel-arm randomized, single-masked clinical trial enrolled patients attending the Tabriz University of Medical Sciences School of Dentistry, who were candidates for immediate implant placement in the maxillary anterior region. After implant placement, the control sites (n=11) received autogenous bone grafts. In contrast, the intervention sites (n=11) received autogenous dentin grafts to fill the horizontal gap between the implant and the buccal wall (jumping gap). A connective tissue graft was subsequently placed in both groups to enhance buccal soft tissue. Buccal bone thickness (measured 2 mm and 5 mm below the marginal crest) and soft tissue thickness were measured at two points at the time of surgery and again six months postoperatively. Data were analyzed using paired t-tests to assess changes within each group and independent t-tests to compare differences between the two groups.

RESULTS

Both groups showed significant increases in buccal bone and soft tissue thickness compared with baseline. At 2 mm below the marginal crest, buccal bone thickness did not differ significantly between the two groups (P=0.401). At 5 mm below the marginal crest, the autogenous bone graft group showed significantly greater bone thickness (2.15±0.21 mm) than the dentin graft group (1.50±0.53 mm, P=0.001). There was no significant difference in buccal soft tissue thickness changes between the bone graft (1.15±0.18 mm) and dentin graft (1.1±0.17 mm) groups.

CONCLUSION

Both autogenous dentin and bone grafts effectively enhanced buccal bone and soft tissue thickness around immediate implants. Autogenous bone grafts produced significantly greater increases in buccal bone at 5 mm below the marginal crest. Trial Registration. Iranian Registry of Clinical Trials (IRCT), IRCT20110726007128N11, Trial ID 86072.