Second stage surgery was done after six months for loading.. Implant was immediately placed after extraction. There was no cortical fracture nor dehisence when implant was loaded.
I think by use of a bone graft ( allograft or xenograft) with a resorbable membrane this problem may be managed. Ofcourse the implant should be submerged after this procedure for atleast 6 months.
I think that is related to another factors like degree and amount of bone loss & pocket & occlusion & size of implant &quality of bone & .....
An allograft with a membrane cover is the answer, as already suggested.
Immediately placed implants in the aesthetic zone are frequently placed too bucally-especially if no flap is raised-because of the socket orientation. If a buccal plate of at least 1-1,5 mm thick is not there for suficient blood supply, then resorption occurs.
If this is the case at hand then no graft will ever replace the missing bone.
You might be lucky enough to correct the aesthetic problem with soft tissue grafting.
There is a significant body of literature which addresses this in the scientific databases. Bone loss associated with second stage surgery is the result of the remodelling following the surgical procedure.The literature also addresses the methods of minimization of this bone loss. I would suggest you can get the full answer if you read the multiple papers.
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