The Impact of Sticky Bone Gap Augmentation on Buccal Bone Preservation After Immediate Implants in Maxillary Single Rooted Teeth: A Randomized Controlled Clinical Trial

Introduction: Immediate implant placement reduces treatment time and preserves prosthetic outcomes but often leaves a peri‑implant "jumping gap" between implant and buccal socket wall. The need to graft this gap remains controversial. This randomized study assessed whether filling the peri‑implant gap with sticky bone improves hard‑tissue preservation and implant stability for single‑rooted maxillary teeth. Materials and methods: Thirteen patients (16 implants; age 20-43 years) requiring extraction of single‑rooted maxillary anterior or premolar teeth were randomized into two equal groups. Group 1 (control) received immediate implants without grafting (n = 8); Group 2 (study) received immediate implants with sticky bone grafting of jumping gaps ≥2 mm (n = 8). ROOTT implants (10-12 mm length; 3.5-4.2 mm diameter) were placed following a standardized surgical protocol. Clinical assessment and CBCT were performed immediately and at 6 months. Outcomes included buccal bone width (at 2, 4, 6 mm levels), crestal bone loss, CBCT‑derived bone density (NewTom Giano HR), and implant stability (Osstell ISQ). Statistical analysis used Shapiro–Wilk, independent‑samples t tests, and paired‑samples t tests (α = 0.05). Results: All implants survived at 6 months (100% survival). Grafted sites showed a significant increase in buccal bone width (mean change +33.7%) versus significant reduction in controls (-25.9%; P < 0.001). Crestal bone loss was greater in control than grafted sites (P = 0.007). Bone density and ISQ increased significantly over time in both groups but did not differ between groups in 6 months. Conclusion: Within 6 months, sticky bone grafting of peri‑implant gaps during immediate implant placement preserved buccal contours and reduced marginal bone loss. Larger, longer‑term studies with histologic evaluation are recommended.