Long-term clinical and radiographic results after treatment or no treatment of small buccal bone dehiscences at posterior dental implants - A randomized, controlled clinical trial.

AIM to test whether or not buccal vertical bone dehiscences (≤5 mm) around posterior implants left for spontaneous healing (SH) result in the same clinical and radiological outcome as dehiscences treated with guided bone regeneration (GBR) at 7.5 years after implant placement. MATERIALS AND METHODS 22 patients receiving 28 posterior implants with a small non-contained buccal bone dehiscence (≤5 mm) were randomly assigned to the SH or the GBR group. Implants were loaded at six months. Clinical parameters (PD, SBI, PI) and approximal marginal radiographic bone levels were assessed regularly up to at least 6.8 years. The vertical extension of the dehiscences was measured clinically at implant placement and abutment connection and radiographically on CBCTs at a mean follow up time of 7.5 years. RESULTS 20 patients with a total of 26 implants were recalled at 7.5 years (9.1% drop-out). The implant/crown survival rates were 100% in both groups. Stable peri-implant tissues were observed in both groups showing only minimal signs of inflammation. During the entire study period (implant placement - 7.5years follow-up) the median buccal vertical bone gain measured 1.61 mm for the GBR group and 0.62 for the SH group showing no significant difference between the groups. Also, at 7.5 years, the median approximal marginal bone levels (GBR: 0.53; SH: 0.68) were not significantly different between the two groups (p=0.61) while the remaining median buccal vertical dehiscences were larger in the spontaneous healing group (SH) (2.51 mm) compared to the GBR group (1.66 mm) (p=0.02). CONCLUSIONS Implants with small non-contained buccal bone dehiscences exhibited high implant survival rates and healthy peri-implant tissues at 7.5 years. In the GBR group, the buccal vertical bone levels were higher compared to the SH group but remained stable over the entire study period for both treatments.

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