Connective Tissue Graft Used As a Biologic Barrier to Cover an Immediate Implant

Background: The purpose of the present study was to evaluate the clinical efficacy of placing implants in fresh extraction sites with simultaneous connective tissue grafting. The teeth selected for this treatment showed gingival recession and/or absence of attached gingiva.

Methods: Ten patients (five men and five women), 42 to 55 years of age, were included in the study. After initial examination and treatment planning, all of the patients selected for the study underwent periodontal treatment that was deemed necessary to favor wound healing. Subsequently, the teeth were extracted, and implants were placed without reflection of a mucoperiosteal flap. Immediately after implantation, a connective tissue graft was placed over the implants to treat the gingival recession. The second stage of surgery was performed 6 months after the initial procedure. The following clinical parameters were evaluated for each patient at 6 and 12 months after implant placement and connective tissue grafting: probing depth, probing attachment level, and mobility. Radiographs were taken using a standardized method to evaluate the marginal bone loss. Esthetic outcomes were evaluated using the measurements before implant placement and 12 months after surgery: width of the keratinized mucosa, emergence profile of the crown, and patient satisfaction.

Results: The healing period was uneventful for all patients. All of the implants had osseointegrated. At the end of the 12-month follow-up, the patients were asymptomatic, and the implant sites showed no signs of infection or bleeding when probed. The parameters used to estimate the esthetic outcomes showed an improvement.

Conclusions: Implant placement immediately after tooth extraction with simultaneous connective tissue graft was considered a successful procedure. Moreover, the surgical approach used in this study can be considered a treatment option in cases with non-salvageable teeth showing gingival recession and the absence of attached gingiva.