Immediate implant placement in compromised extraction sockets using vestibular socket therapy with acellular dermal matrix versus connective tissue grafts in the esthetic zone: a randomized controlled clinical trial.

Abstract

Background: Immediate implant placement (IIP) in compromised extraction sockets poses significant challenges in maintaining the contour and level of mucosal tissues. This study compares the efficacy of vestibular socket therapy (VST) combined with acellular dermal matrix (ADM) versus connective tissue grafts (CTG) in IIP within the esthetic zone.

Methods: Twenty participants requiring extraction in the maxillary esthetic zone were randomized into two groups: ADM and CTG (n = 10 each). Both groups underwent VST with bone grafting and dental implant placement. Clinical outcomes were evaluated at baseline, 6 months, and 12 months, measuring soft-tissue level and thicknesses, and the radiographic facial alveolar bone thicknesses and height.

Results: Both groups resulted in statistically significant increase in coronal mucosal thickness, facial bone height and thickness over time. CTG showed statistically significant increase at apical mucosal thickness over time, whereas the ADM group had a significantly higher facial bone height after 12 months. No significant differences were observed between groups in mucosal thickness and level at any time point and both groups achieved 100% implant survival.

Conclusion: ADM and CTG are both effective for soft tissue augmentation and hard-tissue maintenance in IIP within compromised extraction sockets after 12 months. CTG may offer advantages in apical mucosal thickness, while ADM was associated with greater bone height.

Clinical relevance: Both ADM and CTG effectively enhance soft tissue and maintain hard-tissue levels, with CTG providing better apical mucosal thickness and ADM resulting in greater facial bone height after 12 months. These insights help clinicians to customize treatment plans based on individual goals and patient needs.