CBCTanalysis On Peri-implant Bone Characteristics For Different Implant Treatment Protocols

Objectives: To compare bone structure parameters at immediate and delayedimplant treatment protocols on CBCT images.Materials and Methods: Ethical approval was obtained to carry out a split mouthstudy in6mongrel dogs. The3rdmaxillary incisor besides the3rdand4thmandibularpremolar were extracted. Then dogs randomly received one out of3treatment protocols:normal extraction socket healing (serving as control); immediate implant placement andimmediate loading (IIP+IL); delayed implant placement and delayed loading (DIP+DL).Thirty-six alveolar bone biopsies were scanned using high resolution Cone BeamComputed Tomography (Accuitomo170CBCT). The bone structural parameters werecalculated in a1mm circular-shaped region around the middle of the implant by CTAnsoftware (SkyScan). The results were analyzed using R software (v2.8.1).Results: There were significant differences (p<0.05) in bone characteristics forcontrol vs. IIP+IL and DIP+DL for bone surface volume ratio (BS/BV), fractaldimension (FD), trabecular number (Tb.N), trabecular separation (Tb.Sp) andconnectivity density (Conn.Dn). The IIP+IL had a significantly higher value than thecontrol for Tb.N, BS/BV and Conn.Dn, while a significantly lower value was found forTb.Sp. However, no difference was observed between IIP+IL vs. DIP+DL.Conclusion: Within the limitations of this animal study, it is suggested that theimmediate implant placement and loading protocol may have an improved bonestructural integration compared to that obtained by normal extraction healing. Thepresent findings do not seem to suggest a different bone remodeling pattern when usinga delayed vs. an immediate implant placement and loading protocol.