Immediate Implant Placement in the Infected Site with Presence of a Pre-Existing Cyst: Report of Two Cases

Abstract

Aim: The purpose of this report is to illustrate the possibility of inserting immediate implants into the fresh extraction sockets in the infected site with presence of a pre-existing cyst. Presentation of case: The 1 of two cases: A 31-year-old man, presented to severe periodontitis with presence of a pre-existing infected cysts developed, which was 5mm × 7mm on the labial side of mandible. The radiography showed that a large translucent image around the periapical portion of 31 with mobility of II° in mandible. The extraction and implantation including bone grafting to substitute 31 tooth had been performed in one appointment. One implant (14mm length × 3.7mm in diameter SIN implants Dentis, made in Korea) was inserted apically through a cyst cavity. Three months later, the second surgery phase (healing screw insertion) had been followed, and no sign of alternation of radiography and clinical indication after 18 months. The other, a 53-year-old man came to our attention, with presence of a pre-existing infected cyst on labial side of 42 tooth. We placed one implant in the infected position of the mandible with a small amount of heterologous bone after the elimination of the infected 42 tooth, the meticulous cleaning, and alveolar debridement. A second surgery phase had been done after three months. Discussion and conclusion: This report showed that the placement of immediate implants in presence of a pre-existing infected cyst may not be necessarily contraindicated if appropriate clinical procedures like antibiotic administration, meticulous cleaning, and alveolar debridement are performed before implant surgical procedure. Immediate placement of implants for replacement of teeth with the pre-existing infected cysts is a predictable treatment and can be indicated for replacing teeth lost. This report regards the immediate placement of an implant into a residual cyst; some anatomical, surgery techniques, clinical and pathological considerations arise from this case. Both implants were successfully osseointegrated, and the cysts were healed.