Use of Demineralized Autologous Dentin Graft with the Tooth Processing Device in Immediate Post-Extraction Implant Placement and Loading: A 12-Month Evaluation of Peri-Implant Soft Tissue Stability

Purpose: To evaluate the effectiveness of immediate implant placement and loading combined with autologous dentin grafting in reducing post-extraction tissue remodelling, with particular emphasis on peri-implant soft tissue stability in the esthetic zone. Materials and Methods: This retrospective observational study included 13 patients (14 implant sites) with Type 1 extraction sockets in the anterior maxilla. Following atraumatic tooth extraction, implants were immediately placed and grafted with autologous dentin processed from the extracted tooth using the Tooth Transformer device. Screw-retained provisional restorations were immediately delivered through a digital workflow, and definitive restorations replicated the provisional transmucosal profile. Soft tissue dimensional changes were evaluated by superimposing stereolithography (STL) files from intraoral scans acquired before treatment and after at least 12 months. Vertical changes were measured as a single value, while horizontal changes were assessed 2 and 4 mm apical to the gingival margin. Results: All implants remained clinically stable, with no biological or prosthetic complications. Mean vertical soft tissue collapse was 0.69 mm, while mean horizontal collapse was 0.71 mm at 2 mm and 0.57 mm at 4 mm apical to the gingival margin. In most cases, dimensional changes were below 1 mm, with greater contour alterations at the more coronal level. Conclusions: Within the limitations of this study, immediate implant placement and loading combined with autologous dentin grafting using the Tooth Transformer device resulted in limited peri-implant soft tissue alterations after 12 months. This protocol may represent a biologically favourable, minimally invasive approach for ridge preservation while avoiding donor site morbidity and heterologous grafting materials.