Anatomy of the buccal bone plate in the esthetic zone of the maxilla indicates its susceptibility to significant resorption after the extraction of a tooth. Immediate dental implant placement helps to maintain the stability of the surrounding tissues but is incapable of stopping the resorption entirely. This systematic review aims to compare two major surgical protocol factors that could impact the amount of bone remodulation after immediate dental implant placement - full-thickness flap elevation and bone grafting. A systematic review was carried out according to the PRISMA guidelines. Only prospective clinical trials which evaluated buccal bone plate of maxilla volumetric changes using CBCT scans pre-operatively and 6-12 months post-operatively were included. A total of 358 publications were identified after the initial search. 8 studies with a total of 272 surgery sites met our inclusion criteria and were included. Results were divided into four categories according to the surgical procedures performed. However, subgroup data heterogeneity was identified, thus no trustworthy intergroup comparison could be performed. However, this study confirms that the buccal bone plate of maxilla resorption after immediate implantation is yet inevitable. Only a tendency could be noted that the flapless procedure and graft placement results in better buccal bone plate stability.
