Implant Placement at the Time of Maxillary Molar Extraction: Technique and Report of Preliminary Results of 83 Sites

Abstract

The purpose of this study was to evaluate the predictability of implant placement at the time of maxillary molar extraction using a modified insertion technique and implant design. At the time of maxillary molar extraction, 83 tapered-end implants with an apical diameter of 4.1 mm and a neck diameter of 6.5 mm were placed in maxillary first or second molar sites, following manipulation of the remaining interradicular bone with osteotomes. Regenerative materials, consisting of demineralized freeze-dried bone allograft (DFDBA) and/or osseous coagulum, and bioabsorbable or non-resorbable membranes were placed, and passive soft-tissue primary closure was attained in all cases. Soft-tissue closure was maintained until the time of clinical reentry 6 months after implant insertion in 81 of 83 sites. Loss of primary soft-tissue closure in the other two areas did not result in complete uncovering of the cover screw and implant top. All implants were clinically immobile at the time of implant uncovery 6 months after insertion and were restored with single crowns. All implants were functioning successfully for up to 18 months (mean: 12.4 months). The combination of atraumatic removal of hopeless maxillary molars, controlled manipulation of the residual interradicular bone, insertion of implants of the aforementioned design, and use of appropriate regenerative materials at the time of implant insertion predictably afforded a stable implant for restoration with a single crown.