Immediate Non-functional Loading of Single Tooth Uniti™ Implants into Avulsed Tooth Sockets Following Ridge Augmentation in the Anterior Maxilla: A Case Series

To assess the clinical effectiveness of immediate non-functional loading of single-tooth implant placed into avulsed tooth socket following ridge augmentation in the anterior maxilla with bioglass bone substitute and biocollagen membrane. The clinical outcome of immediate non-functional loaded implants up to 24 months after placement into avulsed tooth sockets in anterior maxilla were evaluated in 15 patients. Implants were immediately restored with acrylic resin provisional crowns. Post-operative follow-up and intraoral radiographs were obtained at 6, 12, 18 and 24 months. Survival rate, implant threads exposure immediately after placement and at 6 month interval using CT 3D reconstruction was assessed. Marginal bone loss did not extend beyond the first thread and 3D CT scan showed adequate bone mineral density with no signs of radiolucent lesion around the implant during 24 months follow-up having survival rate of 100 %. Within the limits of the present study, immediate non-functional loading of single tooth implant placed into avulsed tooth socket following augmentation with bioglass bone substitute and biocollagen membrane in the anterior maxilla is one of the viable treatment alternatives for rehabilitation of immediate loading implant.     

炎症期拔牙后即刻种植：禁忌症或适应症？

目的：探讨炎症期拔牙后即刻种植的可能性及手术技巧，为即刻种植手术适应症的科学界定提供参考依据。方法：12例患者各一枚前牙或前磨牙拔除后即刻种植。拔牙原因为慢性牙周炎、慢性根尖周炎及根管内吸收伴感染等。术后随访l—2年，观察种植体周围炎、GI、种植体稳定性及X线变化等临床指标，评价临床疗效。结果：除1例种植体周骨壁侧穿失败外，其余11枚种植体均获临床成功。结论：由于121腔内血运丰富，抗感染能力强，加之拔牙后激活的炎性反应，故除急性期外，炎症期拔牙并非即刻种植绝对手术禁忌症。非翻瓣式一期法术式及微创手术操作，有利于避免术后感染。     

Immediate placement of anatomically shaped dental implants

Immediate placement of dental implants into tooth extraction sites is an effective treatment option. When immediate placement procedures are performed with a round implant, a void is often evident between the implant and the orifice of the socket. Previous treatment focused on the use of membranes or special closure techniques to induce bone growth into the void. Anatomically shaped dental implants provide a predictable alternative to previous filling techniques since the anatomical implants decrease or completely fill the void at the socket opening. This article describes a surgical technique developed for the immediate placement of these implants in extraction sites.     

Immediate implant placement: diagnosis, treatment planning and treatment steps/or successful outcomes

Diagnosis and treatment planning are key factors in achieving successful outcomes after placing and restoring implants placed immediately after tooth extraction. The efficacy of immediate implant placement has been established and shown to be predictable if reasonable guidelines are followed. Some or all of the following suggestions, depending on individual circumstances should be considered when evaluating a patient for dental implants: thorough medical and dental histories, clinical photographs, study casts, periapical and panogram radiographs, as well as a linear tomography or computerized tomography of the proposed implant sites. Reasons for tooth extraction include, but are not limited to, insufficient crown to root ratios, remaining root length, periodontal attachment levels, periodontal health of teeth adjacent to the proposed implant sites, unrestorable caries, root fractures with large endodontic posts, root resorption, teeth with deep furcation invasions being considered as abutments for fixed partial dentures, and questionable teeth in need of endodontic retreatment. Teeth requiring root amputations, hemisections or advanced periodontal procedures may have a questionable prognosis, and patients should be given the implant option before these procedures are implemented. Similarly, nonvital teeth, fractured at the gingival margin with roots shorter than 13 mm should be considered for the implant option. This review will describe the steps for immediate implant placement at the time of extraction as well as the "gap" and socket preservation.     

Immediate post-extraction implants subject to immediate loading: a meta-analytic study

Since Br?nemark first started developing its implant system, there has been a continuous and significant evolution in oral implantology through experimental and clinical research, and many of the concepts that were once considered valid have now become the subject of debate. The insertion of the implant immediately after extraction of the tooth to be substituted has now become the implant treatment of choice and is associated with preserving the bone structure and the gingival architecture, as well as with reducing the treatment time, which ultimately benefits the patient. Objective: To evaluate the success rate of the immediate post-extraction implants (IPI) subject to immediate loading. Study Design: A meta-analytic study was carried out on 659 immediate post-extraction implants obtained from a bibliographic review of 25 articles published within the last 9 years. Results: We obtained a sample of 322 patients who had been treated with a total of 659 implants placed immediately following extraction. The mean age of the patients was 51 years old. A total of 441 implants were inserted in the maxilla, 152 in the mandible and 64 were placed in an unspecified location. The survival rate ranged between 85% and 100%. Conclusions: Immediate post-extraction implant treatment is an implant alternative with a survival rate similar to that of the conventional technique for implant placement and enables preserving both the bone structure and gingival architecture, as well as providing immediate functional loading, thus improving the quality of the treatment as far as the patient is concerned.     

Immediate Implant Placement: A Case Report

This case report describes extraction of a fractured left maxillary lateral incisor tooth, followed by immediate placement of a dental implant in the prepared socket and temporization by a bonded restoration. The tooth was atraumatically extracted, the socket was prepared to the required depth and a Biohorizon Implant was inserted followed a week later by temporization by a bonded restoration. An impression was made 4 months after implant insertion, and a definitive restoration was placed. The atraumatic operating technique and the immediate insertion of the Implant resulted in the preservation of the hard and soft tissues at the extraction site. The patient exhibited no clinical or radiologic complications through 5 years of clinical monitoring. The dental implant and provisional restoration provided the patient with immediate esthetics, function, comfort, and most importantly preservation of tissues.     

Immediate tooth extraction,placement of a Tapered Screw-Vent implant,and provisionalization in the esthetic zone: a case report

PURPOSE: This clinical report describes an immediate tooth extraction, followed by placement and provisional restoration of a dental implant in the prepared socket of a right maxillary central incisor. MATERIALS AND METHODS: The tooth was extracted with minimal hard and soft tissue trauma and without flap reflection. A flapless, transmucosal surgical approach was used to prepare the socket and insert a tapered implant. The implant was immediately restored with a provisional abutment and crown without occlusal contacts. An impression was made 22 days after implant insertion, and a definitive, all-ceramic restoration was placed 3 days later. RESULTS: During the period of provisional progressive loading, no significant soft tissue contraction was observed related to noninvasive operating techniques and the immediate insertion of the provisional restoration. The patient exhibited no clinical or radiologic complications through 8 months of clinical monitoring after loading. CONCLUSION: The Tapered Screw-Vent implant and all-ceramic restoration provided the patient with immediate esthetics, function, and comfort without any complications during the postloading follow-up period.     

Are success and survival rates of early implant placement higher than immediate implant placement?

Immediate placement refers to the placement of an implant into a tooth socket at the time of extraction; early placement refers to the placement of an implant after substantial gingival healing, but before any clinically significant bone fill occurs within the socket. This study evaluated the success and survival rates of implants following immediate and early placement. 50 implants were placed in 36 patients. 26 immediate (group I) and 24 early placements (group II) were performed. Pain or tenderness with function, mobility, radiographic bone loss from initial surgery and exudate history were evaluated. Mean vertical bone loss in the immediate placement group was 0.55 mm and 0.80 mm in the early placement group. The survival rate for the immediate placement group was 96.16% with 51.6 months follow-up and in the early placement group was 100% with 61.9 months follow-up. The results of this study suggest that although the success and survival rates of early placed implants were a little higher and the follow up period was longer than immediately placed implants, the difference was not remarkable. In conclusion, both implant insertion techniques are safe and reliable procedures with considerably high survival rates.     

Identification of stability changes for immediately placed dental implants

PURPOSE: To evaluate the changes in stability of immediately placed implants over a 6-month healing period relative to implants placed in native bone and to compare the stability of 2 different implant designs when placed as immediate implants in extraction sites. MATERIALS AND METHODS: This prospective cohort study evaluated 3 implant patient populations. The control group (9 patients, 11 implants) required a single-stage, 1-piece, rough-surface implant (considered a "standard" implant) placed in nongrafted sites at least 6 months postextraction. The 2 experimental groups (25 patients, 28 implants) required extraction and immediate placement of either standard implants (12 patients) or tapered, self-tapping implants (13 patients). Immediate implant placement was carried out at the time of tooth extraction. Resonance frequency analysis (RFA), a measure of implant stability, was performed following implant placement at 2- to 4-week intervals for the first 16 weeks and at 24 weeks for immediate implants. RESULTS: Placement protocol (control versus immediate placement) resulted in significant (P < .001) differences in implant stability, even though there was no difference (P > .90) in initial, mechanical implant stability between these groups. The immediately placed implants had significantly greater reductions in stability, approximately 15%, from baseline to 4 weeks. Immediate implant stability was consistent with that of implants placed in native bone after 12 to 16 weeks. Implant design did not have a significant effect on stability. CONCLUSIONS: This study demonstrates that immediate placement protocols are viable options and that standard-design implants may provide levels of biologic stability similar to a tapered, self-tapping implant design in immediate placement protocols. Most importantly, this study documents high levels of metabolic activity in the supporting osseous tissue following immediate placement, which may extend time to restoration compared with traditional implant placement.     

Timing of implant placement relative to tooth extraction

Summary  In recent years, immediate or early implant placement after tooth extraction has becoming more common. The present review focuses on the clinical outcome of immediate or early implant placement. Only limited knowledge exists about most of the factors with particular significance for this treatment mode. Randomized controlled clinical studies comparing the various treatment protocols are scarce. With the background in the existing literature some conclusions can be drawn with caution. Survival rates for implants placed immediately, early, delayed, or late seem to be similar in the short perspective and amounts to approximately 95%. Successful immediate implant placement may be possible in all regions of the jaws, although replacement of molars is more challenging. Chronic infection is not an absolute contraindication for immediate implant placement. It is controversial whether immediate placement of implants may preserve the alveolar bone. Small gaps between implant surface and socket wall have a potential for spontaneous healing. No consensus exists on the need for bone augmentation in these situations. With the limited information available it may be stated that a good prognosis can be obtained following immediate/early functional or non-functional loading of immediately placed implants. However, higher risk of failures seems to exist compared with a delayed, conventional approach. It is advocated that this treatment modality should be restricted to skilled well-trained teams. Data on the aesthetic outcomes following immediate/early implant placement are inconclusive, but this treatment can offer high patient satisfaction with the aesthetic and functional outcomes.     

Immediate implant placement and restoration in infected sites

The long-standing assumption that active infection is a contraindication for immediate implant placement has been challenged recently. High implant survival rates have been reported even when implants were placed immediately in infected extraction sockets and provisionalized within 36 hours. To further evaluate the impact of nonocclusal loading on implants placed in cleaned periodontically or endodontically infected extraction sites, this retrospective study examined the results of 77 implants placed in 63 patients and followed for between 3 and 24 months. Initial primary stability was achieved for all implants, and reverse torque testing at 3 and 4 months postoperatively showed 76 of 77 implants (98.7%) to be successfully osseointegrated.     

Immediate implant placement: treatment planning and surgical steps for successful outcomes

Diagnosis and treatment planning are key factors in achieving successful outcomes after placing and restoring implants placed immediately after tooth extraction. The efficacy of immediate implant placement has been established and shown to be predictable if reasonable guidelines are followed. Some or all of the following suggestions, depending on individual circumstances, should be considered when evaluating a patient for dental implants: thorough medical and dental histories, clinical photographs, study casts, periapical and panogram radiographs as well as a linear tomography or computerised tomography of the proposed implant sites. Reasons for tooth extraction include but are not limited to: insufficient crown to root ratios, remaining root length, periodontal attachment levels, periodontal health of teeth adjacent to the proposed implant sites, unrestorable caries, root fractures with large endodontic posts, root resorption, teeth with deep furcation invasions being considered as abutments for fixed partial dentures and questionable teeth in need of endodontic retreatment.     

Immediate placement of bone level Sraumann implants: a case series

Endosseous dental implants have revolutionized the methods clinicians use to treat edentulous and partially edentulous patients. Traditional implant protocol specifies a healing period of several months after tooth extraction, as well as an unloaded healing period prior to restoration. Over the last decade, numerous studies have documented successful immediate placement of endosseous dental implants in fresh extraction sites and have found positive results with early functional loading. The purpose of this article is to present a clinical treatment protocol for the immediate placement and early loading of dental implants and to report the clinical and radiographic outcomes of the SLActive surface Straumann Bone Level implant placed in either maxillary or mandibular fresh extraction sockets.     

Electronic percussive testing of the stability of an immediately provisionalized implant placed into a fresh extraction socket: a pilot evaluation

It is important to achieve primary stabilization of dental implants that will be immediately loaded. Noninvasive devices that test the stability of immediately provisionalized implants placed into fresh extraction sockets are discussed. A titanium threaded implant was placed into a fresh extraction socket of a patient's nonrestorable mandibular right canine. The implant received an interim restoration immediately following its placement. The stability of the bone-implant complex was evaluated from the day of implant insertion through day 246 using an electronic percussive testing instrument. During the first month the bone-implant complex became progressively less stable reaching a peak measured level of instability at 30 days postimplantation. This was followed by progressive stabilization first measured on day 46 as the implant continued to osseointegrate. These findings suggest that the bone-implant complex became less stable during the first month after implant placement and was followed by a period of progressive stabilization reflecting bone maturation around the implant. A search of the literature found similar results in a study of single-stage implants (not immediately provisionalized) using resonance frequency analysis. The known sequence of wound healing around dental implants is reviewed to explain the findings of this pilot evaluation. Studies that use noninvasive testing devices to assess implant stability at placement and during healing may provide information that can help to optimize implant treatment outcomes.     

Immediate and delayed implant placement into extraction sockets: a 5-year report

Background: As a complement to the earlier reported 3‐year results from a prospective multicenter study of immediate and delayed placement of implants into fresh extraction sockets, the 5‐year results are reported. Purpose: The purpose of this 5‐year report was to evaluate the immediate and long‐term success of implants placed into fresh extraction sockets, with respect to implant size and type, bone quality and quantity, implant position, initial socket depth, and reason for tooth extraction. Materials and Methods: This paper presents the 5‐year results of the original 12 centers that participated with 143 consecutively included patients. A total of 264 implants were placed either immediately after tooth extraction or after a short soft‐tissue healing time (3–5 weeks). The patients were divided into five subgroups, depending on the type of insertion method used. Results: The outcome demonstrated that the cumulative implant survival rate after 5 years of loading has not changed and remains 92.4% in the maxilla and 94.7% in the mandible. No difference in failure rates can be seen between the groups when relating the failures to insertion method. Conclusion: This prospective study demonstrated that placing Brånemark implants into fresh extraction sites can be successful over a period of 5 years of loading. One of the outcomes of the study shows that there is a clinical correlation between implant failure and periodontitis as a reason for tooth extraction, even if it is difficult to give it a casual association. It can be hypothesized that periodontitis affected tissues might have a negative local influence because of the presence of infrabony defects that could possibly increase the gap between bone and implant or jeopardize achievement of primary stability.     

Freestanding and multiunit immediate loading of the expandable implant: an up-to-40-month prospective survival study

STATEMENT OF PROBLEM: The subject of immediate loading of dental implants has received substantial attention, although it appears to conflict with the basic principles of dental implant therapies developed and established over the past 20 years. Clinicians would welcome the use of a reliable, immediate-loading implant system. PURPOSE: The purpose of this study was to evaluate the effectiveness of an expandable implant design for immediate and delayed loading and for freestanding and multiunit situations. MATERIAL AND METHODS: Two hundred eighty-six immediate-load Sargon implants were placed in 75 patients during a 40-month period. Of the 273 implants that survived, 81 were placed into fresh extraction sockets and immediately loaded, 162 were placed into healed sites and immediately loaded, and 30 were delay loaded. Some implants that had failed to remain stable after immediate loading became stable and osseointegrated after the load was removed and their expansion mechanisms were reactivated. RESULTS: The overall survival rate during the 40-month period was 96.0% in the maxilla and 94.8% in the mandible. Implants placed in fresh extraction sockets showed a 98.9% survival rate. Healed sites showed a 93.9% survival rate. Immediate loading of 52 fresh extraction socket implants in the maxilla showed a 100% survival rate during the evaluation period. CONCLUSION: Within the limitations of this study, it was shown that the feature of mechanical expandability may provide operators some control over implant stability during the vulnerable period after immediate loading of single, freestanding implants.     

Immediate transmucosal implants using the principle of guided tissue regeneration. I. Rationale, clinical procedures and 30‐month results.

The installation of implants directly into extraction sockets offers considerable advantages over other treatment modalities for both practitioners and patients. Usually, immediate implants are placed and subsequently covered by mucosa allowing a submerged healing mode. This report presents the rationale, clinical procedures and results for immediate transmucosal implants. Following an intracrevicular incision and flap elevation, the tooth to be extracted is carefully luxated by means of small elevators to preserve the entire bony housing of the tooth. A titanium plasma‐sprayed implant (ITI Bonefit®) is then installed at the bottom or in the wall of the extraction socket. An expanded polytetrafluoroethylene barrier membrane (Gore‐Tex GTAM®) is tightly adapted around the implant post and over the bony margins of the alveolus. The flaps are then replaced, adapted around the neck of the implant and sutured. During nonsubmerged, transmucosal healing of the site, meticulous plaque control is performed by mechanical and chemical means. Membranes are removed after 5–7 months. Since infection was prevented, the implants obtained stability, healthy peri‐implant mucosal tissues were observed and missing bone in the alveoli regenerated. Of 21 transmucosal implants placed into fresh extraction sockets, 20 yielded complete bone fill and coverage of the entire plasma‐coated implants surface at the time of membrane removal. This documentation suggests that the immediate nonsubmerged installation of an implant into an extraction socket is a predictable treatment modality with good long‐term prognosis.     

前牙区即刻种植的临床研究

目的　评价前牙区即刻种植的临床效果。方法　共对 132例患者前牙区患牙 /种植体拔出后 ,分情况即刻植入BLB、Br&nemark、ITI及Frialit- 2　 4种种植系统共 173颗 ,对其进行定期的临床和放射学检查。结果　 173颗即刻种植前牙种植体 ,其中 83颗行引导骨再生技术 ,经 6个月以上观察 ,失败 4颗 ,1颗弃用。结论　如种植体取得良好的初期稳定性 ,对种植体与拔牙窝间存在大于 1mm的间隙 ,采用引导再生膜技术处理 ,即刻种植可以取得良好的临床效果。     

Immediate implant placement and provisionalization--two case reports.

Endosseous dental implants have traditionally been placed using a two-stage surgical procedure with a 6- to 12-month healing period following tooth extraction. In order to decrease healing time, protocols were introduced that included immediate implant placement and provisionalization following tooth extraction. Although survival rates for this technique are high, postoperative gingival shrinkage and bone resorption in the aesthetic zone are potential limitations. The two case reports described herein present a surgical technique for the preservation of anterior aesthetics that combines minimally invasive extraction, immediate implant placement, provisionalization, and the use of implants with a laser micro-grooved coronal design.     

Bio-oss骨胶原在即刻种植中的临床应用研究

目的:探讨Bio-oss骨胶原在即刻种植中的临床应用。方法:拔除患牙,采用Xive种植系统的操作方法,将Xive种植体即刻植入拔牙区,骨量不足处植入Bio-oss骨胶原。3-6个月后进行Ⅱ期手术,10天后进行固定修复。结果:22枚即刻种植的Xive种植体中,上颌16枚,下颌6枚,观察最长24个月,最短12个月,种植体存留率为100%。结论:Bio-oss骨胶原在Xive即刻种植的临床应用结果满意,其长期效果有待进一步观察。