Abstract
The esthetics and functional integrity of the periodontal tissue may be compromised by dental loss. Immediate implants became a viable option to maintain the periodontal architecture because of their anatomic compatibility with the dental socket and the possibility of eliminating local contamination. This article describes the procedure of immediate implant placement in the anterior maxilla replacing teeth with chronic periapical lesions, which were condemned due to endodontic lesions persisting after failed endodontic treatment and endodontic surgery, and discusses the relationship between the procedure and periapical lesions. Surgical removal of hopeless teeth 11, 12 and 21 was performed conservatively in such a way to preserve the anatomy and gingival esthetics. A second surgical access was gained at the apical level, allowing the debridement of the surgical chamber for elimination of the periapical lesion, visual orientation for setting of the implants and filling of the surgical chamber with xenogenous bovine bone graft. After this procedure, the bone chamber was covered with an absorbent membrane and the healing screws were positioned on the implants. Later, a provisional partial removable denture was installed and the implants were inserted after 6 months. After 3 years of rehabilitation, the implants present satisfactory functional and esthetic conditions, suggesting that immediate implant placement combined with guided bone regeneration may be indicated for replacing teeth lost due to chronic periapical lesions with endodontic failure history in the anterior maxilla.
Highlights
Endodontic failures, like persistent infections, must be considered among the factors that lead to tooth loss
Considering that immediate implants may be placed into infected sockets, this paper describes this procedure and addresses the outcomes of immediate implant placement in the anterior maxilla replacing teeth with chronic periapical lesions
Aiming to reduce the process of alveolar bone resorption and treatment time, the immediate placement of endosseous implants into extraction sockets has been propagated by some authors [1,14]
Summary
Endodontic failures, like persistent infections, must be considered among the factors that lead to tooth loss. Alveolar ridge resorption after tooth extraction may considerably reduce the residual bone volume and compromise the favorable positioning of implants required for optimal restoration [3] This is even more pronounced in the anterior maxilla, Correspondence: Prof. Additional benefits, which are valued by patients, are the avoidance of a second surgical intervention and the reduction in rehabilitation treatment time These situations of periapical pathosis conventionally contraindicate their immediate replacement with endosseous dental implants [6,7]. Novaes Jr. and Novaes [11] reported that, in immediate implant placement for replacement of teeth with periapical lesions, success can be achieved if certain preoperative and postoperative measures are followed before surgery, such as antibiotic administration, meticulous cleaning, and alveolar debridement. Considering that immediate implants may be placed into infected sockets, this paper describes this procedure and addresses the outcomes of immediate implant placement in the anterior maxilla replacing teeth with chronic periapical lesions
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