Infected Sockets Research Articles

Soft and hard tissue evaluation for vestibular socket therapy of immediately placed implants in infected and non-infected sockets: a 1-year prospective cohort study

BackgroundImmediate implant placement using vestibular socket therapy (VST) proved to offer a successful treatment option in compromised sockets. However, the presence of active signs infection complicates immediate implants in sockets with defective labial plates, due to the possible contamination of the implant or the bone graft with existing infected tissues or oral environment via the fistula. This study, therefore, aims to explore the success of immediate implant placement using VST in managing infected compromised sockets.MethodsWe included 26 age- and sex-matched patients with 41 implants sites. Thirteen patients had 19 infected (group I) and 13 had 21 non-infected type 2 sockets (group N). Both groups were treated using vestibular socket therapy (VST) and a 6-day protocol. Implant survival, changes in facial bone thickness, and mid, mesial, and distal mucosal levels were evaluated 1 year after implant placement. The Mann–Whitney U test was used to compare both groups. Furthermore, the Wilcoxon signed-rank test was used to study changes with time within each group. The statistical significance level was set at P < 0.05.ResultsAll implants survived; no significant difference was found between groups N and I regarding apical, mid, and crestal bone thickness and soft tissue level, except at the mesial papilla, where the recession was significantly more in group N than in group I. Changes over time were statistically significant in the apical, mid, and crestal bone thickness in both groups. The mean bone thickness gain ranged from 0.85 to 2.4 mm and 0.26–1.63 mm in groups I and N, respectively. Additionally, the mean mucosal recession ranged from 0.29 to 0.51 mm and 0.39–1.47 mm in groups I and N, respectively.ConclusionWithin the limitations of this study immediate implant placement in type II infected sockets using the 6-day protocol and VST achieved 100% implant survival, while maintaining the regenerated facial bone thickness with minimal mucosal recession.Trial registrationThe protocol for this study was registered on clinicaltrials.gov at 3/10/2021 (registration number NCT04787224).

A PCR based study to evaluate the effectiveness of photodynamic therapy in extraction socket disinfection

The purpose of this study was to assess the efficacy of (Light-Activated) Photodynamic therapy in extraction socket disinfection. The goal is to assess the quantitative and qualitative changes in microbial load following the use of photodynamic therapy in extraction socket disinfection. This study included 20 patients ranging in age from 18 to 55 years who required extraction of non-restorable teeth or those with periapical lesions. Extraction was done under local anesthesia, following the principles of atraumatic extraction for socket preservation. Pre-operative samples were collected with paper points for real-time polymerase chain reaction (PCR) analysis. A photosensitizer, Methylene blue dye, was applied for 60 seconds. The PDT laser (660nm) was used for a total of 3 minutes, with 20 second intervals. Following PDT application, repeat samples were collected for PCR analysis to determine the bactericidal effect in socket disinfection. The results showed a predominance of P. gingivalis, a potential periodontal pathogen, and a significant reduction in the same following the application of light activated PDT. Photodynamic therapy has demonstrated promising bactericidal effects, which can improve postoperative outcomes and be considered as one treatment option for immediate implants in infected sockets.

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.

Comparison of Prophylactic Effects between Localized Biomimetic Minocycline and Systematic Amoxicillin on Implants Placed Immediately in Infected Sockets.

This study evaluated the prophylactic effect of localized biomimetic minocycline and systemic amoxicillin on immediate implant placement at infected extraction sites. Twelve mongrels with six implants each were randomly assigned to five groups: uninfected negative control (Group N); infected with oral complex bacteria (Group P); infected and treated with amoxicillin one hour before implant placement (Group A); infected and treated with minocycline during implant placement (Group B); and infected and treated with amoxicillin one hour before implant placement and with minocycline during implant placement (Group C). Radiographic bone level, gingival index (GI), probing depth (PD), papillary bleeding index (PBI), and removal torque (RT) were recorded. There was no significant difference between Groups A, B, and C for bone loss. Group A showed the highest RT, the lowest PBI, and significantly lower GI and PD values than Group P. Group B exhibited significantly higher RT value than Group N and significantly smaller PD value than Group P at 6 w postoperatively. Localized minocycline could improve implant success by reducing bone loss and increasing RT and systemic amoxicillin could maintain the stability of the peri-implant soft tissue. However, combined use of these two antibiotics did not augment the prophylactic effect.

Effect of manuka honey socket dressing on postoperative sequelae and complications following third molar extraction: A randomized controlled study

To evaluate the effect of manuka honey on the healing of mandibular third molar extraction sockets.This was a prospective randomized study at a tertiary health institution in Lagos, Nigeria. All extractions were transalveolar, using the distobuccal bone guttering technique. Participants were randomized into two study groups. Group A underwent intrasocket application of manuka honey, after which sockets were completely closed using the mucosal flap, while participants in group B underwent mucosal flap closure of the socket without application of manuka honey. The primary outcome was healing of the extraction socket at 7 days postoperatively. The secondary outcomes measured were postoperative sequelae, namely pain, swelling, and trismus on postoperative days 1, 3, and 7, and socket healing complications — specifically inflamed socket, infected socket, and alveolar osteitis.In total, 112 participants completed the study, with 56 participants per group. There were no significant differences in demographic variables between both groups. On the 7th day postoperatively, 26.8% of participants in group B had an unhealed extraction site, compared with 10.3% of participants in group A (p = 0.029).A significant difference was observed between pre- and postoperative pain scores in both study groups (p = 0.001). A comparison of postoperative mean facial swelling between the two groups showed no statistically significant differences on all the review days (p = 0.66). The difference in postoperative socket healing complication rate between both groups was statistically significant (χ2 = 4.747, p = 0.029).Within the limitations of the study it seems that the application of manuka honey appears to aid earlier healing of the third molar extraction socket, with a significantly lower frequency of complications. Therefore, the application of manuka honey is recommended whenever appropriate.

Implant Survival Rate After Immediate Implantation in Infected Sockets: A Systematic Literature Review

Implant Survival Rate After Immediate Implantation in Infected Sockets: A Systematic Literature Review

Atraumatic Extraction Followed By Immediate Implant Placement In An Infected Tooth Socket: A Clinical And Radiographic Study

Aim and Objectives: The present study was undertaken to assess success rate of immediately placed implant in infected dento- alveolar sockets with simultaneous placement of PRF gel in the horizontal gap between implant and bone, PRF membrane covering implant using a two stage protocol. Methods : Implants were immediately placed in 12 patients following a 2-stage submerged protocol. The extraction sockets were irrigated with tetracycline solution. PRF was used to fill the gap between the implant body and the surrounding socket wall. The final restoration was placed after 3-months following implant placement. The modified plaque index (MPI) and modified bleeding index (MPI) were measured at baseline and 3 months. Vertical and horizontal bone loss was measured at baseline, 6 and 9 months using IOPA with grid scale. Result : The mean FMPI score was 0.35±0.03 and at 6 months it was 0.25±0.03. At 9 months follow up, the FMPI was slightly increased as compared to the baseline, but the increase was not significant. The mean horizontal bone level at mesial surface of implant at baseline was 0.20±0.25mm, at 9 months it was increased to 0.25±0.26mm at mesial surface. Immediate implants with placement of PRF in infected extraction socket, as a 2 stage protocol resulted in horizontal alveolar bone crest resorption of 0.26mm and 0.3 mm on the mesial and distal surface of implant respectively. Conclusion : Atraumatic extraction followed by placement of implant in infected socket with placement of PRF and implant covered by PRF membrane resulted in 100% survival rate. Clinical and radiographic data after 3 months of loading showed that peri- implant tissue was healthy and marginal bone resorption values were minimal around implants.

Immediate dental implant placement in post-extraction-infected sites decontaminated with Er,Cr:YSGG laser: a retrospective cohort study

Dental implants placed in fresh extraction alveoli provide several advantages, including shorter treatment periods and improved patient comfort. After a compromised tooth extraction, the Er,Cr:YSGG laser can considerably reduce bacterial concentration. The objective of this controlled study conducted after at least 1 year of follow-up was to compare the use of immediate post-extraction implants in infected sites treated with laser (test group) versus conventional implants in edentulous sites (control group) through an analysis of pre- and post-operative radiographs. The study was based on a series of patients treated between 2014 and 2019, with a 1-year minimum follow-up, and up to over 4 years. An analysis of the clinical history of the treated patients and pre- and post-operative radiographs was performed to evaluate the implant success and to measure the marginal bone level (MBL). Overall, 149 implants were studied. There was only one failure in the test group (1%) and no failures in the control group. The test group gained 0.1 mm of the MBL compared to the baseline, while the control group lost 0.1 mm of the MBL. The difference between the two groups of only 0.2 mm was not statistically significant (P = 0.058). Immediate dental implants in infected sockets debrided and decontaminated using Er,Cr:YSGG laser do not appear to enhance the likelihood of failure; however, peri-implantitis and associated problems must be avoided by following a certain set of protocols and procedures.

Immediate Implant Placement in Infected Sockets: Curettage Protocol Plus Disinfection with Hydrogen Peroxide and Rifamycin. Retrospective Analysis at 6 years of Follow-up

Context: Immediate implant placement in a fresh socket after extraction is an increasingly popular and established treatment option. However, active infection at the extraction site can adversely affect the outcome of this procedure. Aims: This study was designed to evaluate the clinical results of immediate dental implant placement in infected extraction sockets. Settings and Design: using a standardized protocol, which included the use of 3% hydrogen peroxide plus rifamycin 500 mg as irrigation for decontamination of the infected socket before implant insertion with submerged healing. Patients and methods: The sample consisted of 227 implants placed in 158 patients, the data were obtained through a retrospective review of the clinical registry selected of patients who received implants according to the protocol described. Statistical analysis used: A generalized binary response regression model was used. For all tests, the statistical significance value was set at p &lt;0.05. Results: Of the 227 implants placed immediately in the infected sites using the described protocol with an average follow-up of 6 years of prosthetic loading, only 11 failed, resulting in a cumulative implant survival rate of 95.2%. Only the medical history / harmful habits factor (HM / HH) was significant (p = 0.002), in this group the success rate was 85.7%. However, in the group of healthy patients without harmful habits, the success rate rises to 98.8%. Conclusion: Immediate implant placement in infected sites using these protocols in healthy patients shows a survival rate similar to that published for implants placed in non-infected sites.

Treat and Restore Compromised Sockets Immediately with the Novel Vestibular Socket Therapy : A Revolution in Immediate Implant Placement

Immediate implant placement is now-a-days one of the promising modalities for replacing missing teeth as it helps restore form and function for a patient within a short period of time. However, presence of active infection within such freshly extracted sockets could jeopardize the success of aforesaid therapy. Although, a variety of techniques have been studied till date, there still remains a need for a treatment modality that could restore freshly extracted infected sockets with inadequate hardtissues. Since presence of adequate hard and soft tissues surrounding an implant is essential for prognosis of dental implant. A novel treatment modality named as Vestibular Socket Therapy (VST) has gained popularity to conventional two-staged approach forrestoring infected sockets. VST could be considered as an effective alternative to placement of dental implants within inadequate hard and soft tissues along with infected freshly extracted sockets.

Evaluation of clinical efficacy of immediate implant placement into debrided infected sockets using demineralized freeze-dried bone allograft and platelet rich fibrin membrane: a clinical trial

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The aim of the study was to evaluate the clinical efficacy of demineralised freeze dried bone allograft (DFDBA) and platelet rich fibrin (PRF) membrane in immediate implant placement into debrided infected mandibular molar sockets.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A clinical trial was conducted on 15 adult patients requiring tooth extraction and replacement with endosseous implants. Atraumatic tooth extraction was followed by thorough debridement of the socket prior to implant placement. Demineralized freeze dried bone allograft and PRF membranes were used for guided bone regeneration. Pain, signs of infection, vertical bone height measurements (IS-BIC) and stability of implants (torque values) were assessed using paired t test, analysis of variance (ANOVA) and Chi-square test.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Statistically significant reduction in pain from immediate post-operative (post-op) day to 1&lt;sup&gt;st&lt;/sup&gt; post-op day, 7&lt;sup&gt;th&lt;/sup&gt; post-op day to 4 months post-op (p=0.006) was seen. Infection was present preoperatively and absent post-op 1&lt;sup&gt;st&lt;/sup&gt; day, 7&lt;sup&gt;th&lt;/sup&gt; day and 4 month in all the subjects. The mean IS-BIC was 2.30±2.27 mm post-op and 0.75±0.74 mm at 4 months. Average height gain on mesial and distal side was 1.55 mm (p=0.009).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;With proper pre-op and post-op care, immediate implant placement along with DFDBA and PRF membrane in teeth exhibiting periapical pathology, is a cost effective, time saving and reliable treatment option.&lt;/p&gt;

Post extraction immediate implant placement in infected extraction sockets of maxillary posterior teeth combined with guided bone regeneration. Two-years prospective clinical and radiographic outcomes

Post extraction immediate implant placement in infected extraction sockets of maxillary posterior teeth combined with guided bone regeneration. Two-years prospective clinical and radiographic outcomes

Compromised extraction sockets: a new classification and prevalence involving both soft and hard tissue loss.

PurposePrevious studies have solely focused on fresh extraction sockets, whereas in clinical settings, alveolar sockets are commonly associated with chronic inflammation. Because the extent of tissue destruction varies depending on the origin and the severity of inflammation, infected alveolar sockets may display various configurations of their remaining soft and hard tissues following tooth extraction. The aim of this study was to classify infected alveolar sockets and to provide the appropriate treatment approaches.MethodsA proposed classification of extraction sockets with chronic inflammation was developed based upon the morphology of the bone defect and soft tissue at the time of tooth extraction. The prevalence of each type of the suggested classification was determined retrospectively in a cohort of patients who underwent, between 2011 and 2015, immediate bone grafting procedures (ridge preservation/augmentation) after tooth extractions at Seoul National University Dental Hospital.ResultsThe extraction sockets were classified into 5 types: type I, type II, type III, type IV (A & B), and type V. In this system, the severity of bone and soft tissue breakdown increases from type I to type V, while the reconstruction potential and treatment predictability decrease according to the same sequence of socket types. The retrospective screening of the included extraction sites revealed that most of the sockets assigned to ridge preservation displayed features of type IV (86.87%).ConclusionsThe present article classified different types of commonly observed infected sockets based on diverse levels of ridge destruction. Type IV sockets, featuring an advanced breakdown of alveolar bone, appear to be more frequent than the other socket types.

Antibacterial and Osteogenic Functionalization of Titanium With Silicon/Copper-Doped High-Energy Shot Peening-Assisted Micro-Arc Oxidation Technique.

Antibacterial and osteogenic functionalization of titanium (Ti) implants will greatly expand their clinical indications in immediate implant therapy, accelerate osteointegration, and enhance long-term prognosis. We had recently shown that the high-energy shot peening (HESP)-assisted micro-arc oxidation (MAO) significantly improved the bioactivity and coating stability of Ti-based substrates. In this study, we further functionalized Ti with antibacterial and osteogenic properties by doping silicon (Si) and/or copper (Cu) ions into HESP/MAO-treated coatings. Physicochemical characterization displayed that the doping of Si and Cu in HESP/MAO-treated coatings (Si/Cu-MAO) did not significantly change their surface topography, roughness, crystal structure, coating thickness, bonding strength, and wettability. The results of X-ray photoelectron spectroscopy (XPS) showed that Si and Cu in the Si/Cu-MAO coating was in the form of silicate radical (SiO32–) and bivalent copper (Cu2+), respectively. The total amounts of Si and Cu were about 13.5 and 5.8 μg/cm2, which released about 33.2 and 31.3% within 14 day, respectively. Compared with the control group (MAO), Si doping samples (MAO-Si) significantly increased the cell viability, alkaline phosphatase (ALP) activity, mineralization and osteogenic genes (ALP, collagen I and osteocalcin) expression of MC3T3-E1 cells. Furthermore, the addition of Cu presented good bactericidal property against both Staphylococcus aureus and Streptococcus mutans (even under the co-culture condition of bacteria and MC3T3-E1 cells): the bacteriostatic rate of both bacteria was over 95%. In conclusion, the novel bioactive Si/Cu-MAO coating with antibacterial and osteogenic properties is a promising functionalization method for orthopedic and dental implants, especially in the immediate implant treatment with an infected socket.

Immediate Implant Placement in Non-Infected Sockets versus Infected Sockets: a Systematic Review and Meta-Analysis

ABSTRACTObjectivesThe aim of this systematic review is to compare immediate implant placement in infected extraction sockets with non-infected extraction sockets in terms of implant survival and function.Material and MethodsAn electronic search was conducted in PubMed, ScienceDirect, ISI Web of Knowledge and Google Scholar between January 2010 and February 2020. Studies evaluating implant survival rate and main clinical parameters were included for a qualitative and quantitative analysis.ResultsIn total, nine studies were included and a pool of 2281 sockets were analysed. Compared with the non-infected group, the infected group showed no significant differences in implant survival rates (risk ratio [RR] = 0.99; 95% confidence interval [CI] = 0.98 to 1; P = 0.08). No significant statistical differences were found in marginal bone level (mean difference [MD] = -0.03; 95% CI = -0.1 to 0.04; P = 0.41), marginal gingival level (MD = -0.07; 95% CI = -0.17 to 0.04; P = 0.23), probing depth (MD = 0.06; 95% CI = -0.24 to 0.36; P = 0.7), modified bleeding index (MD = -0.00162196; 95% CI = -0.09 to 0.09; P = 0.97) and slight but significant changes were seen in width of keratinized gingiva (MD = 0.25; 95% CI = -0.3 to 0.8; P = 0.38) between the groups at the latest follow-up.ConclusionsThere were no significant difference in implant survival rates, marginal bone level, marginal gingival level, modified bleeding index and probing depth between infected sockets and non-infected sockets. However, slight but significant changes were seen in width of keratinized gingiva favouring the non-infected group.

Immediate Implant Placement in Infected Sockets: A Consecutive Cohort Study.

Introduction: Immediate placement of implants in a fresh post-extraction socket is an increasingly popular and established treatment option. However, active infection in the extraction site may adversely affect the outcome of this procedure. This study was designed to assess the clinical results of immediate placement of dental implants in infected extraction sockets using a standardized protocol, which included (a) the use of an Er,Cr:YSGG laser for the decontamination of the infected socket prior to implant insertion, and (b) the utilization of an in situ hardening alloplastic bone graft substitute to augment the gap between the implant surface and the labial plate of bone. Patients and Methods: A retrospective record review was used to identify 68 patients who had implants placed as per the described protocol. A total of 126 implants were placed in 68 patients (65 implants in the maxilla, 61 implants in the mandible). The implants were loaded 136 ± 73 days (mean ± standard deviation; range: 37-400 days) after implant placement. Eight patients (16 implants) were subsequently lost to follow up. Results: 105 of the 110 implants (95.45%) placed immediately in the infected sites using the described protocol survived after prosthetic loading. Conclusion: Immediate implant placement in previously infected sites using the protocols mentioned in our study with laser decontamination of the socket, grafting with an in situ hardening alloplastic bone graft material and non-submerged healing shows a similar survival rate to the published success rates for immediate implants placed in non-infected sites.

Histologic Analyses of Immediate Implant Placement in Infected and Noninfected Sockets: An Experimental Pilot Study in Beagle Dogs.

To investigate the histologic differences between immediate implants placed in chronically infected sites and noninfected sites in a canine model. The histologic results of immediate implant placement also were evaluated on the basis of healing time and implant surface modification. Chronic endodontic-periodontic combined lesions were induced on the second, third, and fourth premolars of the hemimandible in six dogs, with the contralateral teeth as controls. Implants were immediately placed following the infected and noninfected tooth extractions using implants with a machined surface, sandblasted with alumina and acid-etched surface, and chemically modified sandblasted with alumina and acid-etched with calcium solution surface. After 1 and 3 months, three dogs were euthanized and the bone-to-implant contact, bone area fraction occupied, buccal and lingual first bone-to-implant contact from the implant platform, and buccal and lingual marginal bone loss were calculated. On histologic evaluation, no inflammation was observed around implants placed in the infected or noninfected sockets. At 1 month, no statistically significant differences were observed between the infected and noninfected sockets in buccal marginal bone loss in the machined implant group (P = .046), lingual first bone-to-implant contact from the implant in the sandblasted with alumina and acid-etched group (P = .046), lingual marginal bone loss in the sandblasted with alumina and acid-etched implant group (P = .028), buccal first bone-to-implant contact from the implant platform in the chemically modified sandblasted with alumina and acid-etched with calcium solution group (P = .028), and lingual first bone-to-implant contact from the implant platform in the chemically modified sandblasted with alumina and acid-etched with calcium solution group (P = .046). At 3 months, no statistically significant differences were observed in parameters between the infected and noninfected sockets for three implant surfaces. Differences between the infected and noninfected sockets were observed between the machined and sandblasted with alumina and acid-etched implant at 1 month (P = .023). Immediate implant placement in an infected socket did not lead to any differences when compared with placement in a noninfected socket when sufficient healing time was provided.

Er,Cr:YSGG Laser Debridement of an Infected Socket for Immediate Implant Placement: A Case Report

IntroductionImmediate implants offer several advantages for patients, and evidence suggests they can be performed in sites with apical infection following thorough debridement. This report demonstrates the successful use of a unique erbium chromium‐doped:yttrium scandium gallium, and garnet (Er,Cr:YSGG) laser tip to degranulate a deep apical infection otherwise inaccessible to traditional instruments prior to implant placement.Case PresentationOne case is presented where a failing mandibular left incisor with a deep peri‐apical infection was replaced with an immediate dental implant. Following removal of the tooth and debridement with conventional instruments, the socket was Er,Cr:YSGG laser‐ablated with a 26‐mm long radial firing tip. The granulation tissue was removed on the laser tip, and an immediate implant was placed which was successfully restored.ConclusionsThis report demonstrates a technique using an Er,Cr:YSGG laser with radial firing tip for debridement of extraction sites. It is a relevant, useful tool in the armamentarium as the laser energy is directed both apically and laterally. This provides a minimally invasive way to debride the site that does not entail osseous removal.

Immediate Implant Placement at a Periapical Lesion Site: A Case Series.

In this report, three representative cases of immediate implant placement (IIP) at infected periradicular sites have been described. Three patients with a previously endodontically treated hopeless tooth, who were referred by the Department of Conservative Dentistry, presented with a draining buccal sinus tract arising from a chronic periapical lesion. After a minimally traumatic tooth extraction, meticulous debridement of the extracted socket was performed followed by IIP with good primary stability. The gap between the implant and bone was filled with deproteinized bovine bone mineral containing 10% porcine collagen and collagen filler. A follow-up examination conducted 2 years after the procedure showed that IIP was successful, with the implants in good functional and esthetic condition without any clinical or radiographic sign of implant failure caused by the pre-existing periapical pathosis. Within the limitations of this study, these cases show that IIP at infected sockets could be considered an alt...

Comparison of stability with two-time use of platelet-rich growth factor versus one-time use of platelet-rich growth factor in immediate placement of dental implant in infected socket.

Purpose:The aim is to evaluate the outcome and compare the stability with two-time use of platelet-rich growth factor (PRGF) versus one-time use of PRGF in immediate placement of dental implant in infected socket.Materials and Methods:This study comprised placement of immediate implant in infected sockets in 100 patients with two-time use of PRGF (Group B) versus one-time use of PRGF (Group A). Proper administration of antibiotics, careful debridement of the socket, and meticulous suturing were done in every case. In Group A, it was placed at the time of immediate implant placement. In Group B, it was placed twice: at the time of placement of implant and 1 month after placement of implant. Clinical assessment of pain and swelling was done. Stability was assessed by radiofrequency analyzer immediately after placement and at follow-up of 2 months and 3 months.Results:The stability of implants with two-time placement of PRGF was more than that with one-time placement of dental implant. All except 14 implants osseointegrated in this study. There was significant decrease of pain and swelling in both the groups from day 1 to week 1 and was nil by 12 weeks.Conclusion:It can be concluded that placement of immediate implant in infected socket with two-time use of PRGF is an effective and better alternative for rehabilitation. However, more studies with longer follow-up and large number of patients are needed to confirm the results of this study.