Single immediate tooth replacement with tissue graft prevents gum recession

When a tooth is replaced with an implant, receding of the gums can become a concern. This leaves areas of root exposed and can be painful for the patient. While a single tooth replacement performed as an immediate, one-step process is an accepted treatment, gum recession occurs more often with this method of implant.

The current issue of the Journal of Oral Implantology reports on a case series of 10 patients who received a single immediate tooth replacement in conjunction with subepithelial connective tissue graft. The tissue graft has proven successful in making gingival, or gum, tissue more resistant to recession.

In the immediate tooth replacement procedure, a failing tooth is removed and an implant is immediately placed into the socket. For the tissue graft, tissue is harvested from the palate using a single incision. The graft material is inserted into a prepared space between the labial bony plate and the gingiva of the extraction site. The graft preserves soft tissue levels, making the gum less likely to recede.

Marginal bone level is another way to gauge the success of an implant. A more recent suggestion, which this study evaluates, is that this bone level can be influenced by the way the implant and abutment connect. "Platform switching"—which refers to the size discrepancy between these two components—can be beneficial in maintaining the marginal bone level.

In this study, patients were evaluated before surgery, at the time of tooth replacement, and at three, six, and twelve months after surgery. One implant failed early in the process, but at one year the remaining nine patients showed good integration of tissue and tooth with minimal loss of marginal bone level or facial gingival level. The authors concluded that with proper implant position and the placement of graft material, a favorable success rate can be achieved.