ACCURACY OF TOOTH GUIDED IMMEDIATE IMPLANT PLACEMENT AT MOLAR REGION (CLINICAL TRIAL)

Abstract

INTRODUCTION: The concept of immediate implant placement has become popular due to reduced trauma and reduced overall treatment time. Removal of molar teeth provides a challenging and intriguing dilemma due to multiple root morphology. In cases of extraction and immediate placement of implants in the molar region, removal of the inter-radicular septum should be avoided to attain initial implant stability at the time of placement, and prevent slipping of the implant into the extraction socket. Following this technique prevents the slippage of the implant and allows the implant to be guided into the inter-radicular septum.OBJECTIVES: To assess the accuracy of implant placement using the remaining roots of multi-radicular mandibular molars, evaluate bone density around implants and implant stability in fresh extracted site.MATERIALS AND METHODS: A prospective study was done on 10 patients with badly destructed mandibular molars. The technique of implant insertion consisted of a progressive preparation of the implant site using the anatomy of the root of the multi-radicular mandibular molars to be extracted as a reference and as an aid to engage the inter-radicular septum. Implant stability was evaluated using Osstell; Radiographic evaluation was done by Cone Beam Computed Tomography.RESULTS: Nine out of ten implants were functioning successfully along the evaluation period, while one implant failed 4 weeks after insertion and was removed. Clinically, implants stability was assessed using Osstell. All implants showed increase in ISQ value after 3 months. Radiographically, immediate postoperative CBCT was carried out which showed implants placed in ideal position. After 6 months, CBCT showed increase in bone density around implants compared to the immediate postoperative CBCT.CONCLUSIONS: Tooth guided immediate implant placement at molar region is a novel technique for easy and safe implant insertion.