Bone Grafting and Post-implant Surgery Flap Blood Perfusion Rate

Objectives: The purpose of this study is to compare the rate of flap recovery from surgical trauma through blood perfusion following implant placement in previously grafted and non-grafted sites in relation to buccal bone remodeling as well as implant stability.
Methods: Patients receiving single implant in the maxillary esthetic zone were recruited. Clinical wound healing parameters and blood perfusion (Laser Doppler Flowmetry [LDF]) were recorded at baseline, immediately after implant placement and at 3, 6, 9 days and 1, 4 months post-surgery. Implant stability and CBCT analysis of buccal bone remodeling were documented immediately following surgery and at 4 months.
Results: 21 patients (46±4 yrs, 10 male; 12 premolar sites; 15 grafted sites) were recruited. Healing was uneventful for all cases. Primary wound closure was obtained in 2 cases (10%) and 17 cases (81%) had clinical wound closure at 1 month. 70% decrease in immediate postoperative blood flow was noted (83% for grafted [p=0.01] and 6% for non-grafted [p>0.05] sites) compared to pre-operative blood flow; this was followed by hyperemic response that persisted up to 12 days for grafted and 40 days for non-grafted sites (time dependent differences for grafted and non-grafted sites; p=0.005 and p=0.9, respectively). Mean implant stability values for grafted and non-grafted sites were 70±2 and 71±3 ISQ at baseline and, 71±2 and 68±3 ISQ at 4 month, respectively (p>0.05). Preliminary CBCT analysis revealed that buccal alveolar bone thickness at crest remains stable in average 50% of the surface area. Additional analyses comparing various anatomical locations on buccal bone surface as well as possible differences between grafted and non-grafted sites are pending.
Conclusions: Within the limits of this study, flap blood perfusion exhibits a persistent hyperemic response at post-implant placement, with differences between previously grafted and non-grafted alveolar bone sites.