Fresh Extraction Sockets Research Articles

Seating Accuracy of Prefabricated Interim Crowns on Immediate and Delayed Implants: A Laboratory Study.

Evaluation of seating accuracy of interim crowns for the immediate restoration of immediate implants (I-Imp) and delayed implants (D-Imp) placed via static computer-assisted implant surgery (sCAIS). A maxillary training model was modified by removing the central incisors and simulating fresh extraction socket in one site and healed ridge on the other site. An I-Imp was planned in the extraction socket and D-Imp was planned in the healed site. The planned implants were used to design sCAIS surgical template and interim crowns for immediate restoration of the implants. Fourteen surgical models received sCAIS implants after which the interim crowns were inserted. Subsequently, the models with the seated crowns were scanned by a laboratory scanner. The planning virtual model was superimposed against every surgical model to measure vertical, horizontal and proximal contact errors of each crown. All the crowns were positioned more incisally than the planned crowns. This was significantly more noticeable for the D-Imp crowns (0.81 mm) than the I-Imp crowns (0.55 mm). The 2 crown groups had similar horizontal errors (I-Imp =0.35 mm, D-Imp = 0.36 mm). The D-Imp crowns had minimal proximal contact error (0.14 mm), but the I-Imp crowns had significantly greater proximal contact error (0.74 mm) in the form of open distal contacts. This pattern of error appears related to the relationship between the socket morphology and the planned implant position. Prefabricated interim I-Imp crowns suffered from greater errors that affected the proximal contact quality than DImp crowns. The observed deviation of the I-Imp crowns can be attributed to the socket morphology and its relation to the planned implant position. The deviations of the I-Imp crowns are clinically significant and will require clinical adjustments. Thus, caution is needed before routine use of prefabricated interim crowns on I-Imp.

Evaluation of ozonated olive oil in the success of immediate dental implants placed into infected sockets

Abstract Purpose This prospective study was conducted to assess the clinical and radiographic influences of topical application of ozonated olive oil on immediate implants inserted into infected fresh extraction sockets. Patients and methods This study was implemented on 14 cases with infected nonrestorable teeth or remaining roots. All cases underwent two-stage implant surgery, stage I: extraction of the tooth, application of ozonated olive oil gel into the infected postextraction socket, and immediate insertion of dental implant fixture, and stage II: 4 months after stage I surgery, the abutment was installed onto the implant fixture. After soft tissue healing around the abutment, the implant was loaded with the final functional prosthesis. All the patients had regular follow-up intervals throughout the study period to evaluate soft tissue and bone healing and implant stability. Results Fourteen patients enrolled in this study, of which there were six (42.9%) males and eight (57.1%) females. The age of the patients ranged between 21 and 45 years with a mean of 33.21 ± 9.16 years. The clinical outcomes including visual analog scale, soft tissue dehiscence, infection, implant stability quotient, gingival index, and peri-implant probing depth all indicated uneventful postoperative healing and 100% survival rate of the implants throughout the follow-up intervals. Radiographic outcome included interpreting cone beam computed tomography measurement of alveolar bone height which showed marked significant positive difference between stage I and stage II surgeries indicating a potential enhancing effect of ozonated olive oil on osseointegration and tissue healing. Conclusion Based on the outcomes of this study, we concluded that topical administration of ozonated olive oil might potentially enhance healing and osseointegration of implants immediately inserted into infected fresh extraction sockets and could exhibit a significant influence on increasing the success rate and minimizing complications. However, further investigation employing a control group, larger sample size, and longer follow-up duration is required to confirm this influence.

Effect of L-PRF and autogenous bone grafts for immediate implant placement in post tooth extract socket.

The clinical outcomes of bone augmentation substances in immediate dental implant (IDI) placement are of interest to dentists. Hence, we evaluated and compared the effectiveness of L-PRF and autogenous bone grafts in immediate implant placement in tooth extract socket. Hence, assessment of periimplantis pocket depth, assessment of tissue biotype, implant stability and marginal bone loss at one month, three months, and six months follow up was completed. The tissue biotype values at one month, 3 month and 6 month follow up revealed that tissue biotype increased in each category as the time increased in all categories. We found that all three techniques were found to have good clinical outcomes regarding immediate implant placement in fresh tooth extraction socket, however the outcomes were better in the case L-PRF.

Clinical and radiographic outcomes of a two-piece ceramic implant: one year results from a prospective clinical trial.

To describe the clinical and radiographic performance and survival rate of a new two-piece ceramic implant system after at least 12 months of follow-up. Sixty-five implants were placed and followed up for at least 12 months (12.3 ± 1.5), in 50 patients. The implants were installed both in fresh extraction sockets and in healed sites and received provisional restoration when the clinical insertion torque was greater than 35Ncm. The primary results describe the survival rate of these implants. Clinical performance was evaluated through the evaluation of the Pink Esthetic Score (PES) and the degree of satisfaction of the patients. Bone loss was measured through radiographic measurements of the marginal bone loss in the mesial (MBLM) and distal (MBLD) sites. The survival rate was 98.5%. The average MBLM was 0.24mm (± 0.53) and the MBLD was 0.27mm (± 0.57). A statistical difference was observed only when comparing immediate implants with delayed ones (MBLM - p = 0.046 and MBLD - p = 0.028) and when they received immediate provisionalization or not (MBLM - p = 0.009 and MBLD - p = 0.040). The PES before the intervention (T0) was 13.4 (± 0.8) and the PES at T2 (12-month follow-up) was 12.9 (± 1.5) (p = 1.14). The new two-piece ceramic implant used in the present study showed predictable and reliable results, similar to those found with titanium implants after one year of follow-up. These implants can be used as an alternative to titanium implants in terms of the marginal bone loss and the degree of patient satisfaction.

RETRACTION: Marginal bone loss evaluation around immediate non-occlusal microthreaded implants placed in fresh extraction sockets in the maxilla: a 3-year study.

J. L. Calvo-Guirado, G. Gómez-Moreno, A. Aguilar-Salvatierra, J. Guardia, R. A. Delgado-Ruiz, G. E. Romanos, "Marginal bone loss evaluation around immediate non-occlusal microthreaded implants placed in fresh extraction sockets in the maxilla: a 3-year study", Clinical Oral Implants Research 26, no. 7 (2015): 761-767, https://doi.org/10.1111/clr.12336 The above article, published online on 15 January 2014 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal's Editor in Chief, Lisa J. A. Heitz-Mayfield; and John Wiley & Sons Ltd. The retraction has been agreed due to concerns raised by third parties on the data presented in the article. Several flaws and inconsistencies between results presented and experimental methods described were found. Specifically, instances of overlapping data within the article and with another publication authored by the same group have been found. Accordingly, the editors consider the findings of this article unreliable and the conclusions to be invalid. The authors have been informed of the decision to retract the article. The corresponding author J. L. Calvo-Guirado and co-author R. A. Delgado-Ruiz disagree with the decision of retraction. The remaining co-authors were not available for a final confirmation of the retraction.

Comparative Evaluation of Immediate Implant Placement in Fresh Extraction Socket with and without the use of Platelet-Rich Fibrin.

Immediate implant placement after tooth extraction has been found to be a workable and reliable treatment for tooth loss based on clinical and radiographic evaluation. This study was conducted for comparative evaluation of immediate implant placement in fresh extraction socket with and without the use of platelet-rich fibrin (PRF). Forty sites in all were chosen, and they were split into two groups at random. Twenty of these were placed immediately with PRF (test category), while the remaining 20 were placed immediately without the use of any comparable adjunct (control group). Using cone beam computed tomography, radiographic characteristics were evaluated both at the time of implant implantation and a year later. The crestal bone at the mesial surface was 2.74 ± 1.44 and 1.96 ± 1.41 mm at baseline and 12-month follow-up in the control group. The crestal bone at the mesial surface was 2.93 ± 1.44 and 2.57 ± 1.57 mm at baseline and 12-month follow-up in the test group. Immediate implant placement in fresh extraction socket showed better results with the use of PRF.

Dynamic analyses of a soft tissue-implant interface: Biological responses to immediate versus delayed dental implants.

To qualitatively and quantitatively evaluate the formation and maturation of peri-implant soft tissues around 'immediate' and 'delayed' implants. Miniaturized titanium implants were placed in either maxillary first molar (mxM1) fresh extraction sockets or healed mxM1 sites in mice. Peri-implant soft tissues were evaluated at multiple timepoints to assess the molecular mechanisms of attachment and the efficacy of the soft tissue as a barrier. A healthy junctional epithelium (JE) served as positive control. No differences were observed in the rate of soft-tissue integration of immediate versus delayed implants; however, overall, mucosal integration took at least twice as long as osseointegration in this model. Qualitative assessment of Vimentin expression over the time course of soft-tissue integration indicated an initially disorganized peri-implant connective tissue envelope that gradually matured with time. Quantitative analyses showed significantly less total collagen in peri-implant connective tissues compared to connective tissue around teeth around implants. Quantitative analyses also showed a gradual increase in expression of hemidesmosomal attachment proteins in the peri-implant epithelium (PIE), which was accompanied by a significant inflammatory marker reduction. Within the timeframe examined, quantitative analyses showed that connective tissue maturation never reached that observed around teeth. Hemidesmosomal attachment protein expression levels were also significantly reduced compared to those in an intact JE, although quantitative analyses indicated that macrophage density in the peri-implant environment was reduced over time, suggesting an improvement in PIE barrier functions. Perhaps most unexpectedly, maturation of the peri-implant soft tissues was a significantly slower process than osseointegration.

Survival analysis of dental implants placed in a private practice. A multicenter prospective cohort study.

This prospective cohort study aimed to assess the predictability and survival rates of dental implant treatment in edentulous patients while identifying potential factors contributing to implant failure. A total of 80 outpatients, receiving 166 dental implants between September 2015 and November 2017 in two private dental clinics, were included in this study. Patient and implant characteristics, surgical procedures, primary stability, prosthetic rehabilitation, failure analysis, and survival rates were analyzed. The majority of patients (53.75%) received a single implant for treating single-gap edentulism, with 6.25% requiring implants for fully edentulous jaws. Most implants (66.87%) were Avinent Ocean IC implants with specific design features. Surgical placement primarily occurred in healed pristine bone (78.31%), immediate implants in fresh extraction sockets (19.88%), and bone regeneration was simultaneous in 15.66% of cases. While 54.82% of implants achieved primary stability over 35Ncm, none exceeded 45Ncm, and only 4.82% failed to attain primary stability. Prosthetic rehabilitation revealed that 13.25% received immediate loading prostheses. During follow-up, four implants failed, resulting in a 2.41% failure rate, with bruxism (HR: 96.62; P< 0.001) and absence of primary stability (HR: 23.54; P< 0.001) significantly associated with implant failure. The cumulative survival rate at 24 months was 97.44%. This study demonstrates the high predictability and survival rates of dental implant treatment in edentulous patients, consistent with established standards. Factors such as bruxism and primary stability may impact early implant failure. Dental implants remain a reliable treatment option, boasting a 97.44% cumulative survival rate at 24 months. Further research is required to explore implant failure indicators and multifactorial influences. Key words:Dental implants, survival, edentulous patients.

Immediate Loading Using the Digitalized Customized Restoration of Single-tooth Implants Placed in Fresh Extraction Sockets in the Aesthetic Anterior Maxilla: A 10-Year Prospective Study of Marginal Bone Level.

The objective of this study was to assess marginal bone level around single implants inserted in fresh extraction sockets in the anterior maxillary region and instantly restored with computer-aided design/computer-aided manufacturing customized temporary crowns cemented on the final abutment. A total of 20 patients (15 females and 5 males, with a mean age of 30 years), where 20 were placed in fresh extraction sockets. After raising a full-thickness flap, atraumatic extraction was performed the implant site was prepared and fixtures were stabilized on the palatal bone wall. The implant location was immediately transmitted to the prepared master model using the pick-up impression coping seated in the surgical guide template. Prefabricated abutments were used as the final abutment on the master model, scanned and the crown was planned using computer-aided manufacturing customized software. Later on 8th weeks, abutments were torqued as per the manufacturer's recommendation, and the final crowns were cemented. Using personalized intraoral radiographs marginal bone level was evaluated mesially and distally to the implant shoulder as a reference at implant placement, 8 weeks, 1, 3, 5, and 10 years after loading. Wholly implants were osteo-integrated positively after 10 years of practical loading, but only 18 were available for clinical and radiological follow-up, and 2 patients with two implants were excluded from the study due to relocation abroad without any implant failure. The average marginal bone loss (MBL) in the current report was 0.16 ± 0.167 mm at crown cementation, 0.275 ± 0.171 mm after 1 year, 0.265 ± 0.171 mm after 3 years, 0.213 ± 0.185 mm after 5 years, and 0.217 ± 0.194 mm at 10 years. The strategy of inserting and not removing the final abutment at the time of implant placement facilitates the establishment of adequate attachment of both soft and hard tissues to the abutment surface, ensuring uninterrupted organization of tissue architecture and offers advantages in helping maintain soft tissue maturation and preventing marginal bone level. Immediately loaded implants in freshly extracted sockets lead to a significant reduction in marginal ridge resorption. The use of a temporary crown on a prefabricated abutment, exclusive of successive abutment manipulation, proved effective in preserving the primarily founding blood clot and served as a prototype for shaping the soft tissue around the previously wounded gum. How to cite this article: Berberi A, El Zoghbi A, Aad G, et al. Immediate Loading Using the Digitalized Customized Restoration of Single-tooth Implants Placed in Fresh Extraction Sockets in the Aesthetic Anterior Maxilla: A 10-Year Prospective Study of Marginal Bone Level. J Contemp Dent Pract 2024;25(3):213-220.

Survival Rate of Immediate Implants in Periodontally Compromised Patients: A Systematic Review

ABSTRACT Background: Immediate implant placement into a fresh extraction socket has been developed as a consistent treatment, allowing for a reduction in the duration of time necessary for prosthetic rehabilitation. The study will evaluate the clinical and radiologic outcomes of implants placed immediately for a 10-year follow-up period. Aim: The aim of this systematic review is to evaluate the durability of the immediate implant in periodontally compromised individual placement. Methods: Studies reporting clinical and radiologic implant outcomes from periodontally compromised individuals who were treated and followed periodontal and implant maintenance for ≥5 years were considered eligible for the review. Screening of the articles, data extraction, and quality assessment were conducted independently and in duplicate. Results: There were 99 papers, and of them, 55 were excluded after title/abstract assessment. The full texts of 28 potentially eligible publications were screened, but only seven studies met the inclusion criteria. Conclusions: The study confirms that immediate implant therapy is safe, effective, and predictable for successful osseointegration and long-term functioning in periodontally compromised individuals, with minimal differences in clinical and radiographic outcomes.

The Long-Term Esthetic and Radiographic Outcome of Implants Placed in the Anterior Maxilla after Ridge Preservation, Combining Bovine Xenograft with Collagen Matrix.

The objective of the study was to evaluate the long-term esthetic and radiographic results of implants placed in the anterior maxilla after ridge preservation, combining bovine xenograft with collagen matrix. Fifteen patients who required a single tooth extraction because of fracture, root resorption, or extended caries were included in the study. After extraction, all sites were grafted using Deproteinized Bovine Bone Mineral (DBBM) with collagen and covered by a resorbable collagen matrix (CM). Five months after socket grafting, implants were successfully installed. The implant diameter range was between 3.8 and 4.2 mm. All patients were monitored for over 7 years, both clinically and radiographically. Three independent observers evaluated the long-term esthetic outcome, employing the Pink Esthetic Score (PES) technique. Over a period exceeding seven years, a 100% survival rate was observed for all 15 implants, with minimal marginal bone loss. The mean PES was 11.40 (±1.44) at the first assessment and 11.38 (±1.63) at the second assessment. The difference was not statistically significant (p = 0.978), and the scores of PES measurements indicated excellent esthetic results even after seven years. Based on these preliminary results, it seems that placing collagen bovine bone in a fresh extraction socket, covered with a collagen matrix, can preserve the alveolar ridge and provide long-term stable esthetic results.

A clinical protocol for immediate dental implant placement in post-extraction-infected sites decontaminated with Er,Cr:YSGG laser.

Placement of dental implants into fresh extraction sockets offers some advantages, such as reduced treatment times and enhanced patient comfort. The Er,Cr:YSGG (Erbium, Chromium-doped: Yttrium, Scandium, Gallium, and Garnet) laser can significantly reduce bacterial concentration after the extraction of a compromised tooth. The aim of this article is to provide a clinical protocol for the management of implants placed in infected extraction sites decontaminated with Er,Cr:YSGG laser. A compromised tooth, which was an abutment for a fixed bridge, with clinical and radiological signs of infection was extracted. The infected site was treated and decontaminated with an Er,Cr:YSGG laser device (Biolase iPlus®) and two implants (Straumann®) were placed in the same surgery, in order to rehabilitate the edentulous area. The intervention was completed by tissue regeneration with biomaterials. Prosthetic rehabilitation after the surgical phase allowed us to provide correct function and satisfactory esthetics. In the follow-up visit, clinicians found good tissue healing and did not observe any complications, such as implant loss or peri-implantitis. The technique used in our study is repeatable and predictable, but patient selection is very important for this type of protocol as the presence of contraindications can lead to failure. The photoacoustic effect exerted by this type of laser has been proven to be effective against many pathogens. Several authors have previously demonstrated the effectiveness of this technique. Immediate implantation in infected sites decontaminated with Er,Cr:YSGG laser does not seem to contribute to an increased risk of failure; however, it is necessary to follow a certain set of protocols and procedures to prevent peri-implantitis and other complications.

Comparison of crestal bone loss and papilla fill after conventional and immediate implant placement: A 12 month clinical and radiographic prospective study

Background The problem of missing teeth persists in all age groups. The main objective of implants in dentistry is to provide a restoration that reconstructs the shape and restores esthetics and functions of edentulous areas. The objectives of this study are to compare the crestal bone level changes and papillary fill after placement of implants in fresh extraction socket, i.e. immediate implant placement, and healed extraction socket, i.e. delayed or conventional implant placement, and to assess other clinical parameters such as modified plaque index (mPI), modified gingival index (mGI) and gingival biotype in between the groups and within the groups. Methods 18 patients were recruited in the study out of which 9 patients received implants as per immediate implant placement protocol (group 1) and 9 patients received implants as per conventional implant placement protocol (group 2). All patients were evaluated for gingival biotype, mPI and mGI and papillary fill was assessed as per Jemt’s papilla score as clinical parameters. Implant site was assessed for radiographic bone loss using Image J software. Statistical analysis was performed using independent t test, paired t test and chi square test. Results At the end of 1 year, results showed that crestal bone loss was seen more in the immediate group than the conventional group. Conventional implants showed better papillary fill than implants placed in fresh extraction sockets. Plaque scores were assessed as per modified plaque index, which showed better results in the conventional group. Modified gingival index was used to assess gingival status which showed better results in the immediate group one year later. Conclusions Findings from the study suggest that crestal bone loss was found to be increased in the immediate group than the conventional group and papillary fill was better in the conventional group than the immediate group. Registration: CTRI (CTRI/2019/09/021340).

Immediate implant in the esthetic area when immediate loading is not an option: a clinical case report

Aims: Tooth extraction in the frontal area is associated with significant bone resorption, especially at sockets presenting with a thin buccal wall, such as most of the maxillary incisors. In the case of favorable residual hard and soft tissue anatomy, immediate implant placement in the esthetic area might be an opportunity to drive the alveolus healing course in the desired direction. Case presentation: In this clinical case, a fractured upper central incisor was replaced by an immediate two-piece implant covered with a healing screw. After 3 months, the implant was restored. The facial and interdental soft tissue was maintained with appreciable success at the 3-year follow-up visit. Conclusion: When immediate loading of the implant is not an option and the fresh extraction socket presents with fair soft tissue quality, the use of an interim healing screw might help sustain and prevent the shrinkage of peri-implant tissues. This simple technique might be a valuable option when there is no indication for adjunctive hard or soft tissue grafting or immediate loading feasibility conditions.

Effects of systemic ozone administration on the fresh extraction sockets healing: a histomorphometric and immunohistochemical study in rats.

Studies have highlighted numerous benefits of ozone therapy in the field of medicine and dentistry, including its antimicrobial efficacy against various pathogenic microorganisms, its ability to modulate the immune system effectively, reduce inflammation, prevent hypoxia, and support tissue regeneration. However, its effects on dental extraction healing remain to be elucidated. .Therefore, this study aimed to evaluate the effects of systemically administered ozone (O3) at different doses in the healing of dental extraction sockets in rats. To this end, 72 Wistar rats were randomly divided into four groups after extraction of the right upper central incisor: Group C - control, no systemic treatment; Group OZ0.3 - animals received a single dose of 0.3 mg/kg O3; Group OZ0.7 - a single dose of 0.7 mg/kg O3; and Group OZ1.0 - a single dose of 1.0 mg/kg O3, intraperitoneally. In total, six animals from each group were euthanized at 7, 14, and 21 days after the commencement of treatment. Bone samples were harvested and further analyzed by descriptive histology, histomorphometry, and immunohistochemistry for osteocalcin (OCN) and tartrate-resistant acid phosphatase (TRAP) protein expression. All applied doses of O3 were shown to increase the percentage of bone tissue (PBT) after 21 days compared to group C. After 14 days, the OZ0.7 and OZ1.0 groups showed significantly higher PBT when compared to group C. The OZ1.0 group presented the most beneficial results regarding PBT among groups, which denotes a dose-dependent response. OCN immunostaining was higher in all groups at 21 days. However, after seven and 14 days, the OZ1.0 group showed a significant increase in OCN immunostaining compared to C group. No differences in TRAP+ osteoclasts were found between groups and time points. Therefore, O3 therapy at higher doses might be beneficial for bone repair of the alveolar socket following tooth extraction.

Augmentation of single tooth extraction socket with deficient buccal walls using bovine xenograft with platelet-rich fibrin membrane

BackgroundDifferent techniques and materials such as bone grafts and bioactive agents have been used for alveolar ridge augmentation in extraction sockets with a defective wall, there is not a specific material or technique that has resulted in superior outcomes or prevented total bone loss.ObjectivesThis clinical study aims to evaluate radiographically the effectiveness of using bovine xenograft with platelet-rich fibrin (PRF) membrane on vertical and horizontal alveolar ridge dimensional changes following tooth extraction that are complicated by buccal bone loss.Materials and methodsThis study was conducted in Egypt on fourteen patients with a single posterior tooth indicated for extraction. A preoperative cone-beam computed tomography (CBCT) scan confirmed more than 50% loss in buccal bone in each tooth. Extraction sockets were packed with minced PRF clots mixed with a bovine xenograft. Each extraction socket was sealed by PRF membranes. CBCT scans, performed before tooth extraction and after 6 months, were used to assess alveolar ridge changes both vertically and horizontally.ResultsThere was a significant gain in the buccal and middle of the extraction socket bone height, recording 86.01% (6.33 mm) and 206.45% (9.6 mm), respectively. There was an insignificant bone loss in the lingual bone height and width, recording − 8.49% (-1.06 mm) and − 13.39% (1.05 mm), respectively. The results also showed a non-significant decrease in alveolar bone density (-14.06%) between pre-operative bone present apical to the extraction socket and newly formed bone inside the socket.ConclusionsRidge preservation/augmentation techniques using a bone graft mixed with PRF and covered by PRF membranes in fresh extraction sockets complicated by the loss of buccal bone result in buccal bone augmentation and a reduction in horizontal and vertical ridge collapse after tooth extraction.Clinical relevanceThe bovine xenograft in conjunction with PRF can be used immediately after extraction for ridge preservation, providing adequate bone width and height for implant placement.

Influence of Crestal Implant Position and Smooth Collar on Marginal Bone Level: A 2-Year Retrospective Radiographic Analysis.

The aim of this retrospective study was to establish the survival rate and the clinical outcome of a an endoosseous implant system and to evaluate the marginal bone level and the impact of the positioning of the machined collar neck on crestal bone level changes up to two years follow-up. 96 implants were placed in 57 patients and loaded with final restoration after at least three months of healing time. 15 of these implants were immediately placed into fresh extraction sockets while 81 implants were inserted in healed ridges. Marginal Bone Loss around implants were determined radiographically after a mean observation time ranging between twelve and twenty-four months after loading. The effect of location (mandible v/s maxilla, anterior v/s posterior), immediate implant v/s native bone, smoking habit, gender, implant length and diameter, the type of prosthesis (screw-retained/cemented) and the positioning of the machined collar on the marginal bone loss was evaluated. Survival rates were evaluated based on the criteria as determined by Misch et al. in 2008. The Survival Rate at the implant level was 98, 96% at 1 year follow-up period. The mean marginal bone level has significantly changed over time in the overall sample after a follow-up period of one year (-p-value<0.001); it (average) decreased significantly by 0.238 mm between baseline and loading (-p-value<0.001; post-hoc test). It also decreased by 0.154 mm between loading and 1 year, however the decline was not significant (-p-value=0.085; post-hoc tests). After a follow-up period of two years, the mean marginal bone level has significantly changed over time in the overall sample (-p-value<0.001); it has decreased significantly by 0.263 mm between baseline and loading. It (Average) has also decreased by 0.111 mm between loading and 1 year and by 0.199 mm between loading and 2 years, but these declines were not significant (-p-value>0.05; post-hoc tests). The mean bone loss after 1-year and 2 years was not significantly associated with implants type, implant site (maxilla/mandible or anterior/posterior implants), smoking habits and type of implant's surgery (-p-value=0.792).However, it was significantly associated with the type of prosthesis; it was significantly elevated with cemented prosthesis compared to screw-retained prosthesis. A supracrestal positioning of the machined collar (tissue level placement) was associated with no bone loss, while placing the smooth part of the implant below the alveolar crest has led to bone loss over 2 years. Marginal bone loss after 1 and 2 years was not significantly associated with implants type, implant site (maxilla/mandible or anterior/posterior implants), smoking habits and type of surgery. However, it was significantly elevated with cemented prosthesis compared to screw-retained prosthesis. It was dependent also on the positioning of the machined collar.

Immediate Tooth Replacement in the Esthetic Zone with the Socket Shield Technique and a Novel Body-Shift Implant: A Pilot Study with Up to 3 Years of Follow-up.

Successful rehabilitation of the anterior maxilla remains a challenge, primarily due to postextraction ridge collapse, which can lead to gingival recession and a nonesthetic appearance. The socket shield technique presents a viable alternative for immediate dental implant placement in the esthetic zone. This pilot study aimed to evaluate the survival, complication rates, and marginal bone loss around body-shift implants placed in fresh extraction sockets with the socket shield technique to replace maxillary incisors. After socket shield preparation, 14 hopeless incisors were extracted and immediately replaced by a body-shift implant (Inverta, Southern Implants) at baseline. Patients were followed up for 12 to 39 months (mean: 18.1 ± 8.2 months). The average age was 52.3 ± 16.9 years, and the survival rate was 100%. One socket shield presented minimal internal exposure that was successfully treated with a connective tissue graft. The mean PES score was 12.9 ± 1.2. Mean interproximal marginal bone loss was -0.4 ± 0.5 mm. Body-shift implants can be a promising alternative for immediate tooth replacement combined with the socket shield technique. The superior esthetic outcomes remained stable, suggesting that the extra space created by the narrow cervical portion of the implant is beneficial for preserving the alveolar bone and limiting internal shield exposure.

Immediate implant placement in fresh extraction sites in the maxillary esthetic zone: a case series with 2-years' follow-up.

The objective of the present case series with 24 months of follow-up was to document the clinicoradiographic status of IDI placed in fresh extraction sockets (FES) in the maxillary esthetic zone (MEZ). Immediate implants were placed in the FES of three adult patients. Medical history and demographics of these patients were retrieved from their respective healthcare records. All extractions were done using atraumatic techniques and performed in the MEZ. Diameter and lengths of IDI ranged between 4-4.1 mm and 14-16 mm, respectively. Osseous drilling was done at 2000 rpm and implants were inserted using an insertion torque of 45 Ncm. All implants were restored with screw-retained ceramic restorations. Follow-up clinicoradiographic investigations were done after 2-years. At follow-up, peri-implant plaque and gingival indices were measured and peri-implant probing depth was measured. Marginal bone loss was also measured. The two-year follow-up clinical and radiographic results from all cases showed that the implant success and survival rates were 100% and 100%, respectively. There was no clinical evidence of peri-implant soft tissue inflammation in all cases. Scores of peri-implant plaque index, bleeding on probing, probing depth and crestal bone loss showed no evidence of peri-implant inflammation at 2-years' follow-up. All implants and their prostheses were clinically stable. It is concluded that IDI can osseointegrate and remain functionally and esthetically stable when placed in FES located in the MEZ.

The Survival Rate of Posterior Immediate Implants in the Maxilla and Mandible: An Observational Retrospective Study of 158 Dental Implants.

Immediate implants are popular for the anterior sextants of the mouth and have shown a high success rate for the same. However, their installation in a fresh extraction socket in the posterior segments can also be beneficial to the patients and limit the time for the patient to start the masticatory function. However, there have been contradicting results in different studies. The primary objective of this retrospective study was to establish correlations between factors such as implant dimensions, implant categories, implant location, and various demographic parameters in relation to the longevity of implants. This investigation was conducted through a comprehensive clinical evaluation of immediate implants situated within the molar sections of both the upper (maxillary) and lower (mandibular) jaws. Between October 2015 and August 2022, a total of 158 implants were implanted, with 87 males and 71 females undergoing implant placement following tooth extraction. All implants were reinstated between 12 and 18 weeks after they were placed. Inferential statistics were performed using SPSS Statistics version 23 (IBM Corp. Released 2015. IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp.). The Chi-square test was employed to determine statistical significance (p=0.05) between survived and failed implants in relation to various study factors. Lastly, in order to measure the survival rate under different time periods after implant placement, the life table method and Kaplan-Meier survival rate analysis were used. Success of implants was observed at 149 sites, whereas implant failure was seen at nine sites in total. From placement to loading, the implant failed at five sites, and the cumulative survival rate was found to be 96.83%, from loading to one year, implant failure was seen at three sites, and the cumulative survival rate was found to be 94.9%, from one to two years after loading implant failure was seen at only one site with cumulative survival rate to be 94.93%. From two to three years after loading, implant failure was not seen at any site. Regardless of implant size or insertion location, rapid implant implantation in fresh extraction sockets can result in predictable clinical outcomes.