Implant placements in alveolar fenestration defects: Report of case series

Implant placement at a site with bone deficiency or fenestration is usually avoided since the prognosis may be poor. However, several studies have recently reported the successful usage of guided bone regeneration in cases with insufficient bone. Although this studies are encouraging placement of implants, the cases with insufficient and infected bone support have been considered a risk. The aim of this study was to evaluate the placement of implants in an alveolar fenestration defects. 

Method:

Patients referred to the oral surgery clinic for implant placement were included in the study. A consecutive series of patients suitable for implant placement after the removal of mucoperiostal flap demonstrated a fenestration defect on the vestibular alveolar region. In all cases, after curettage of granulation tissues membranes, bovine bone graft materials were used. Seven implants in 5 patients (3 male; 2 female, mean age: 41.05) were evaluated for this case series. Patients with inflammatory, exacerbating processes were not included. A two-stage surgical procedure was planned to optimize marginal bone healing. All patients were followed clinically and radiologically. The flaps were subsequently replaced and secured with sutures in such a way that the healing cap of the implant was exposed to the oral environment. All implants had adequate primary stability. Antibiotics and analgesics were prescribed for 5 days.

Result: The implants were loaded with the final restorations after five months. At the six-months follow-up, implants were osseointegrated and functioning.

Conclusion: No complications were observed. Around of the implants no progressive bone loss was demostrated. Implant placement tissues membranes and bovine bone graft materials in an alveolar fenestration defects might be a viable alternative to delayed placement. However, it requires a careful case selection and a specific treatment protocol because it is a very sensitive technique and more difficult to execute than a conventional protocol.