Simultaneous hard and soft tissue augmentation for implants in the esthetic zone: report of 37 consecutive cases.
BACKGROUND
A recent report documented a tissue engineering approach to simultaneously augment hard and soft tissues for implant site preparation. The technique used freeze-dried mineralized bone allograft (FDBA), recombinant human platelet-derived growth factor mixture with a titanium-reinforced membrane, and a pediculated connective tissue graft (PCTG) to simultaneously augment the hard and soft tissue. The aim of this study was to determine the effectiveness of this technique in delayed and immediate implant cases in which specific augmentation materials differed.


METHODS
This retrospective analysis reports on the clinical treatment of subjects requiring maxillary anterior extractions with concomitant loss of the buccal plate. In preparation for an implant-supported restoration, 37 defects were treated with FDBA, differing guided bone regeneration barrier membranes, and PCTG. Twelve subjects underwent immediate implant placement.


RESULTS
All 37 grafted sites healed uneventfully with no complications. Thirty-six implants osseointegrated and were stable and successful at the 6- and 12-month post-restoration evaluations. One immediate implant failed to integrate. The overall success rate was 97.3%.


CONCLUSIONS
This analysis suggested that the interpositional vascularized augmentation neogenesis (IVAN) technique can be used effectively to simultaneously augment hard and soft tissue. This technique is effective when used in conjunction with the immediate or delayed placement of dental implants in the maxillary anterior segment. Furthermore, when using this technique, the specific membrane and FDBA source can be chosen by the practitioner to treat individual defects.