Immediate implant placement in thin buccal bone phenotype: CBCT-based retrospective comparison between DBBM and H-PRF bone block.

PURPOSE: To compare the effect of deproteinized bovine bone mineral (DBBM) alone vs horizontal platelet rich fibrin bone block (H-PRF-BB) in bone augmentation during immediate implant placement with flap surgery in a thin labial bone phenotype.

METHODS

Patients underwent immediate implant placement in the anterior maxilla with horizontal bone augmentation possessing a thin buccal plate (≤1 mm) or small buccal bone defect were included. Cone-beam computed tomography (CBCT) were taken preoperatively (T0) and 6 months postoperatively (T1). Horizontal bone width changes (ΔRWn), bone volume changes (ΔV), and ridge contour remodeling were analyzed and compared between the DBBM alone and H-PRF-BB groups.

RESULTS

A total of 25 patients and 34 implant sites were included. No significant differences were observed in ΔRW0 (0.30 ± 0.50 mm vs. 0.33 ± 0.36 mm, P = .970) or ΔV (34.32 ± 24.41 mm³ vs. 33.55 ± 20.56 mm³, P = .981) between the two groups. ΔRW8 was greater in the H-PRF-BB group (1.16 ± 0.36 mm vs. 0.14 ± 0.21 mm, P = .023). During the healing process, both groups exhibited bone resorption at the alveolar crest in the mesial, central, and distal regions. There was no significant difference in ridge alteration between the two groups. The average changes in vertical direction were 0.91 ± 0.51 mm vs 0.78 ± 0.55 mm (mesial, P > .05), 0.77 ± 0.51 mm vs 1.55 ± 0.31 mm (central, P > .05), and 1.36 ± 0.53 mm vs 1.52 ± 0.38 mm (distal, P > .05). Mean horizontal bone resorption was relatively undetected.

CONCLUSION

H-PRF-BB provided comparable horizontal bone augmentation outcomes to traditional DBBM in immediate implant cases with thin or defected buccal bone. Both techniques resulted in similar ridge contour remodeling, emphasizing the need for further research into the biological determinants of bone healing.