Soft and hard tissue assessment of immediate implant placement: a case series

Objectives : The aim of this prospective study was to evaluate clinically and radiographically the success and esthetic result of immediate implant placement at the time of extraction. Material and methods : Twelve patients with 14 titanium screw-shaped implants (13–16 mm length and 4.3 or 5 mm diameters) were placed in the extraction sockets. Defects after implant placement were recorded, and then filled up with deproteinized bovine bone mineral, bioabsorbable collagen membrane, and absorbable pins. The defect was again re-evaluated at second-stage surgery. Clinical and radiographic parameters of the peri-implant conditions were assessed at the moment of prosthesis placement and at 1-year follow-up. Results : The cumulative implant survival and success rate was 100% after a 1-year observation period. Analysis of the esthetic result showed that the mean pink esthetic score (PES) was 11.1 (SD 1.35) at 1-year follow-up. At 1 year, 64.3% papillae had a score of 2 and the remaining 35.7% score 3 according to the Jemt (1997) papillary index. Optimal value of width of the keratinized mucosa was recorded in 13 (92.9%) implant cases in both periods of follow-up. At 1-year follow-up, the linear distance between implant-shoulder to the bone peaks remains stable with a mean of 2.62±0.2 mm at the mesial and 2.9±0.58 mm at the distal aspect. Conclusion : Careful evaluation of potential extraction sites before immediate implant installation promotes optimal implant esthetics. To cite this article: Juodzbalys G, Wang H-L. Soft and hard tissue assessment of immediate implant placement: a case series. Clin. Oral Impl. Res. 18 , 2007; 237–243 doi:10.1111/j.1600-0501.2006.01312.xPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74957/1/j.1600-0501.2006.01312.x.pd

Replacement of teeth exhibiting periapical pathology by immediate implants: a prospective, controlled clinical trial

OBJECTIVES: The aim of the present study was to test whether or not immediate implantation leads to more biological complications, when performed at extraction sockets of teeth exhibiting periapical pathology compared with teeth not exhibiting periapical pathology. MATERIALS AND METHODS: In 17 consecutively admitted patients, immediate implant placement was planned in order to replace single teeth exhibiting periapical pathology (test group). These teeth demonstrated pain, periapical radiolucency, fistula, suppuration or a combination of these findings. Another 17 consecutively admitted patients in need of single tooth replacement in the absence of periapical pathology served as the control group. Implant placement and accompanying bone regeneration were performed according to standard clinical procedures. Implants were loaded after a healing period of 3 months. Clinical and radiographical parameters were assessed at the time of implant placement (baseline) and at 12 months thereafter. RESULTS: Out of the 34 patients, four test and one control patient had to be withdrawn from the study due to the inability to obtain primary implant stability. The residual 29 implants revealed a survival rate of 100% 1 year after placement. Clinical and radiographical differences between 12 months and baseline comparing test and control groups showed no statistical significances for any of the parameters assessed. Within test and control groups there was a statistically significant loss of vertical bone height at the adjacent teeth (mesial test=0.4+/-0.6 mm, control=0.4+/-0.5 mm; distal test=0.3+/-0.2 mm, control=0.7+/-0.8 mm) as well as at the implant site (mesial test=1.9+/-1.4 mm, control=1.8+/-1.1 mm; distal test=1.7+/-1.4 mm, control=1.6+/-1.1 mm) and of buccal keratinized mucosa (test=-2.2+/-1.2 mm; control=-1.3+/-1.6 mm) between baseline and 12 months. During the first 13 weeks of healing, two sites of the test and one site of the control group showed signs of infection, which required intervention. Neither the incident of early exit nor of signs of infection was statistically significantly different between the test and the control group (Mann-Whitney U test). CONCLUSION: It is concluded that for those implants where primary stability was achieved, the immediate implant placement performed at extraction sockets exhibiting periapical pathology did not lead to an increased rate of complications and rendered an equally favorable type of tissue integration of the implants in both groups. Implant placement into such sites can, therefore, be successfully performed