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J Periodontol. 2010 Jun;81(6):953-7. doi: 10.1902/jop.2010.090749.

Immediate loading of a dental implant placed in fresh socket with acute dehiscence-type defect: a clinical case report.

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Department of Dentistry, Vita Salute University, San Raffaele Hospital, 20132 Milan, Italy.



The aim of the present clinical case is to show buccal bone repair around a dental implant placed by flapless technique and immediately loaded in fresh socket with acute buccal dehiscence-type defect.


A 58-year-old female presented with a fistula on the buccal side and a root fracture at the left lateral incisive. The dental extraction was performed without mucogingival flap elevation; the absence of buccal bone plate was recorded. A screw-shaped implant was placed. Immediately after the surgical procedure, the patient received temporary prosthetic restoration, and 3 months later definitive metal-ceramic restoration was positioned.


Four years later, a fracture of the crown and gingival inflammatory process were observed. The crown was removed and a fracture of the zirconia abutment was reported. Surgical reentry was performed, gingival flap was raised, and buccal bone repair was observed.


Biologically, it is very difficult to explain the bone repair process around implants in the acute dehiscence-type defect, and only biologic speculations explain the outcome of this clinical result.

[Indexed for MEDLINE]

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