Abstract
Placement of postextraction dental implants has become a common practice. Here, we reviewed current literature, along with clinical procedures, outcomes, and incidence of complications, associated with immediate implants in infected postextraction sites. The YSGG (yttrium, scandium, gallium, and garnet) laser can significantly reduce the bacterial concentration after extracting a compromised tooth. We treated a 40-year-old woman with a compromised tooth in the esthetic zone, presenting clinical and radiological signs of infection, particularly a periapical periodontitis. The tooth was extracted after administering local anesthesia using Optocain® (mepivacaine and adrenalin 1 : 100,000), following which the site was treated with an ErCr : YSGG (erbium, chromium-doped yttrium, scandium, gallium, and garnet) 2780 nm laser device (Biolase iPlus®). The implant (Straumann® fixture) was inserted with minimum 35 N torque, 1 mm below the most apical bone peak. Bio-Oss® and resorbable membrane were applied to improve bone healing. The use of ErCr : YSGG laser has ensured success of implant therapy performed on an infected site. There were no complications such as peri-implantitis or loss of peri-implant bone. The implant achieved good primary stability, immediate placement into an infected site did not increase complications, and the 5-year follow-up confirmed the treatment success.
Highlights
Placement of postextraction dental implants has become a common practice, due to its numerous advantages, such as it facilitated maintenance of the horizontal and vertical dimensions of the osseous tissues [1], reduced treatment times, enhanced patient comfort, and good esthetic results
The immediate implant placement technique was first described by Lazzara in 1989 [2]
Recent studies have demonstrated that the presence of a periradicular infection may not compromise immediate implant placement, provided that the site is adequately decontaminated with a disinfection protocol [5]
Summary
Placement of postextraction dental implants has become a common practice, due to its numerous advantages, such as it facilitated maintenance of the horizontal and vertical dimensions of the osseous tissues [1], reduced treatment times, enhanced patient comfort, and good esthetic results. Only a small number of studies report the clinical outcomes of immediate implants inserted in postextraction sockets. One of the primary indications to this technique is the need to replace endodontically compromised teeth in cases when periapical surgery is inadvisable [3]. In such cases, it is imperative to note that certain local and systemic factors may contraindicate placement of the dental implant [4]. Recent studies have demonstrated that the presence of a periradicular infection may not compromise immediate implant placement, provided that the site is adequately decontaminated with a disinfection protocol [5]. The YSGG laser can significantly reduce the bacterial concentration present in the socket of an extracted tooth [6]
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