Placement In Fresh Extraction Sockets Research Articles

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.

Immediate Implants, Immediate Loading, and Milled Double Bar Prosthesis (Titanium, Biohpp): A Case Report

Abstract To rehabilitate lower arch by placing immediate implants and immediate milled provisionals and provide double bar prosthesis for the long-term survival of implants. Full-mouth rehabilitation by integrating cone-beam computed tomography data three-dimensional printing technology helps in precise placement and predictable outcomes to the longevity of implants. Six immediate implants were placed in the lower arch using digitally guided surgery. Computer-aided design-computer-aided manufacture milled temporary prosthesis was also given within 24 h of the surgery. After allowing for osseointegration, the final prosthesis was made up of materials such as titanium (primary bar), PEEK (secondary bar), and high-impact polymer composite crowns. Splinting all the implants together with such framework designs reduces the loads on implants and addition of two bars produces a dampening effect and helps long-term survival of the same. Strategies used to preserve alveolar bone and soft tissue by immediate implant placement in fresh extraction sockets shorten the treatment span. Immediate loading of implants using temporary prosthesis can be done after attaining adequate primary stability. This case has a follow-up of 6 years. The milled double bars made out of titanium and BioHPP h provide dampening effect and thus long-term survival of the implant.

Immediate Implant Placement to replace a retained deciduous tooth -A case report

Implant placement in fresh extraction sockets has been thoroughly established. A waiting period of 12 months or longer to allow total socket healing results in pronounced resorption of buccal and lingual plate of the alveolar ridge. This paradigm has been challenged within the last decade by reducing the time gap between tooth extraction and implant placement. New protocols have been developed in which implants are placed at the time of extraction of the tooth, or soon after, before considerable bone resorption occurs, known as immediate implants. Immediate implant placement is now accepted in clinical dentistry for the rehabilitation of partially or completely edentulous mandible or maxilla. This article describes a case report of immediate placement of implant after extraction of retained deciduous tooth 85 in place of congenitally missing lower right 2 premolar and with conventional implant to replace missing permanent 46.

Sinus floor elevation and simultaneous implant placement in fresh extraction sockets: a systematic review of clinical data.

Combining different procedures to reduce the number of surgical sessions and patient discomfort in implant placement and sinus floor elevation has been recommended, and evidence supports good outcomes. The aim of this study was to review the results of clinical studies on sinus floor elevation through extraction sockets and simultaneous immediate posterior implant placement. An electronic search was carried out in PubMed, Scopus, and Web of Science to find English articles published in or before August 2020. A manual search was also performed. Titles, abstracts, and the full-text of the retrieved articles were studied. Thirteen studies met our eligibility criteria: 6 retrospective case series, 3 case reports, 2 prospective cohort case-series, 1 prospective case series, and 1 randomized controlled trial. Overall, 306 implants were placed; 2 studies reported implant survival rates of 91.7% and 98.57%. The others either did not report the survival rate or reported 100% survival. Sinus floor elevation through a fresh extraction socket and simultaneous immediate implant placement appears to be a predictable modality with a high success rate. However, proper case selection and the expertise of the clinician play fundamental roles in the success of such complex procedures.

Occurrence and severity of spontaneous exposure of cover screw after dental implant placement.

Background Perforation of the soft tissues overlying the dental implant, resulting in early and spontaneous exposure of cover screws between stages I and II of the two-staged implant placement procedure, is a common problem that can disrupt the primary repair and osseointegration process. The present study aimed to investigate the prevalence of spontaneous exposure of cover screws in dental implants and identify the related risk factors.Methods The present retrospective, descriptive-analytical study enrolled 40 patients with 182 dental implants in the second stage of the implant placement procedure. Data on patient-related and implant-related classified variables were collected, and all the samples were examined for cover screw exposure based on the classification by Tal. First, the overall prevalence of cover screw exposure was calculated. Then, statistical analysis was performed using SPSS 24 to investigate the effect of different variables on this exposure. The chi-squared test was used at the bivariate level, while the logistic regression was used at the multivariate level.Results Of 40 participants with 182 implants, 17 implants (9.3%) in 9 patients (22.5%) became exposed to the oral cavity. In terms of severity, Class I exposure was the most common with seven implants. Moreover, Class III was the least common with only one implant. Using the logistic regression analysis, we found significant relationships between the dental implant exposure and the variables of overlying mucosal thickness (OR=24.7, P≤0.001), the duration between tooth extraction and implant placement (OR=9.6, P=0.005), and implant location in the jaw (OR=3.8, P=0.033). Moreover, exposure was more common in the maxillary premolar area (22.5%) than in other locations. Also, there was a significant relationship between implant exposure and lateral augmentation (OR=0.20, P=0.044), indicating the higher risk of exposure in implants with lateral augmentation than those without augmentation.Conclusion Despite the limitations of this retrospective study, its results showed that three factors, including the overlying mucosal thickness of <2 mm, implant placement in fresh extraction sockets, and maxillary implants, especially at the location of maxillary premolars, were strong predictors of spontaneous implant exposure.

Evaluation of Accuracy in Computer Guided Versus Free Hand Immediate Implant Placement in Fresh Extraction Sockets: a Randomized Controlled Clinical Trial

Background: The aim of this study was to compare between computer guided and free hand immediate implant placement in fresh extraction sockets in terms of accuracy of implant positioning.Methods: This is a randomized controlled clinical study, which used CBCT imaging and flapless surgical technique to place implants in fresh extraction sockets. Accuracy measurements were done using BluSky®1software. A total of 22 patients were recruited according to inclusion and exclusion criteria. Results: The mean values at the implant shoulder for implants inserted using computer surgical guides and those inserted using free hand technique in the mesiodistal direction were 0.69 and 1.43mm, respectively. While in the buccolingual direction they were 0.96 and 1.34mm, respectively. At the implant apex in the mesiodistal direction, they were 1.26 and 2.35mm, respectively. While in the buccolingual direction, they were 1.64 and 1.70mm, respectively. For the angular deviation they were 1.57 and 3.18mm respectively in the mesiodistal direction. Whilein the buccolingual direction were 1.29 and 7.76mm, respectively.Conclusions: Accuracy of computer guided immediate implant insertion surpasses the freehand technique in the buccolingual direction in terms of placing Immediate Implants in fresh extraction sockets in maxillary estheticregion and thus the prosthetic aspect.

Bone Ring Autogenous Graft and Immediate Implant Reconstruction in Atrophic Posterior Mandibular Area

Purpose: to evaluate clinical and radiographic outcome of bone ring grafting technique with immediate implant placement in fresh extraction socket in mandibular posterior area. Patients and methods: Clinical study was conducted on six patients, suffer from deficiency in vertical height at posterior mandibular area. Extraction and immediate implant reconstruction with symphyseal bone grafting in one-stage procedure. All steps of harvesting by trephine bur, implant osteotomy and placement within the socket were guided by computerized surgical stent for donor and recipient sites. Platelet Rich Fibrin (PRF) membrane was prepared to cover the implant at suture line. Patients were followed up clinically and radiographically by Cone Beam Computed Tomography (CBCT) at immediate,3 and 6 months postoperatively to evaluate the implant site and vertical bone height changes. Results: One successful case out of six showed excellent soft tissue healing with implant stability. Clinically one case showed sever infection at 2 weeks postoperatively with looseness of implant. Dehiscence and pain were found in 83.3% of the cases. Four cases had mild pain and one case suffered from severe pain, edema was mild in the majority of patients, numbness was found in 4 cases with 66.7%. CBCT results showed significant decrease in 3D dimensions of vertical bone height from immediate postoperative to 6 months with percentage of resorption (Buccally37.49±12.14, Lingually36.12±12.04, Mesially 39.55±15.05 and Distally10.92±0.76). Conclusion: From our study, Bone ring augmentation technique for fresh defective sockets with immediate implants at posterior mandibular area achieved low success rate, long procedure time and donor site morbidity.

Immediate implant placement in fresh extraction sockets

Immediate implant placement (IIP) in fresh extraction sockets exhibits similar survival and success rates to delayed implant placement in healed sockets. Several advantages of IIP involve shortened total treatment time, reduction of the number of invasive surgeries, and subsequent reduction of patient discomfort due to lack of additional surgeries. The major shortcomings in IIP, however, include the inability to obtain early bony support, presence of a gap between the extraction socket and fixture, and the inability to cover the fixture with soft tissue, leading to increased risk of infection and implant loss. When IIP is performed, atraumatic or minimally traumatic extractions, conservation of the septal bone in molars, minimal flap elevation or flapless surgery, bone grafting the gap between the fixture and the extraction socket, and coverage with soft tissue or a membrane must be considered.

A Challenging Approach: Implant Placement in Fresh Extraction Socket with Buccal Plate Defect Using a Novel Technique

As Dental implants have emerged to be one of the best means of rehabilitating a missing tooth, there have been various new advancements taking place in implant dentistry in recent years. It is extremely important to preserve the facial bone and the soft tissue, especially in the esthetic zone. Various such procedures maintain the width of the soft tissue and underlying bone in the esthetic areas. Conventionally it was advisable to wait for at least 3 months after the implant placement, before prosthetically rehabilitating the patient. However, with recent advances, we can provide the patient with immediate implants. This review aims to discuss a technique, which discusses on how we are able to place dental implants in fresh extraction sockets, with a buccal plate defect incorporating a novel surgical method along with usage of both hard and soft tissue grafts, which will enable us to achieve pleasing esthetics for the patient, without causing future facial bone resorption.

Esthetic Outcome of Computer-Guided Versus Free-Hand Immediate Implant Placement In Fresh Extraction Sockets in Esthetic Zone, A Randomized Clinical Trial

Aim: to compare the esthetic outcome of two surgical techniques used in single immediate implant placement(computer guided vs free hand) in the esthetic zone in terms of pink esthetic score (PES) and gingivalrecession (GR).Methods: This was a randomized clinical trial, where twenty patients with a failing tooth in the esthetic zonewere recruited for immediate implant placement and restored with non-functional provisional crowns. Theywere randomly allocated to either computer guided (test group) or free hand (control group). Six monthsafter surgery the patients were restored with their definitive crowns. Pink esthetic score was recorded twice(after surgery and after definitive crown), while gingival recession was recorded after the definitive crown.Results: No statistically significant difference was found between the mean differences of pink esthetic scorebetween both groups and within each group overtime. Regarding gingival recession, 2 implants showedgingival recession in the computer guided group while none in the free hand group.Conclusions: Within the limitations of this study (sample size and follow-up duration), immediate implantplacement using computer guided surgical guides would consume more time, effort and expenses yet itprovided similar results with the free hand which seems beneficial for the learning curve for unexperiencedclinicians.

Patient Satisfaction of Computer-Guided Versus Free- Hand Immediate Implant Placement in Esthetic Zone, A Randomized Controlled Trial

Background: The evolution of minimally invasive concept made flapless implant placement combinedwith CAD/CAM surgical templates superior on free hand immediate implant placement in fresh extractionsocket. Although Patient reported outcome measure in relation to any restoration in the esthetic zoneis a very important criterion, very limited studies reporting patient satisfaction of free hand immediateimplant placement protocol compared with computer guided approach. This study aimed to evaluate patientsatisfaction of computer guided (test group) versus free hand (control group) immediate implant placementin esthetic zone.Materials and Methods: A total of 20 patients with remaining roots in the aesthetic zone and indicatedfor extraction were selected. They were allocated randomly into two equivalent groups of 10participants each. Immediate implant placement was performed using computer aided surgical guide for testgroup and free handed without any surgical guide for the control group. For patient satisfaction assessmenta validated questionnaire was used where each question of the questionnaire was scored by the patients on10 cm visual analogue scale (VAS).Results: No statistically significant difference was found in patient satisfaction between the test and controlgroups.Conclusions: within the limitation of our study, combining a computer aided surgical guide to an immediateimplant placement seems to be a predictable therapy especially for young practitioners.

Esthetic and Prosthetic Rehabilitation of Maxillary Lateral Incisor:A Case Report

The key factors in achieving successful outcomes after implant placement immediately after tooth extraction is a correct diagnosis and treatment planning. The efficacy of immediate implant placement has been established and shown to be predictable if reasonable guidelines are followed. The reasons for tooth extraction may include but not limit to: insufficient crown to root ratios, remaining root length, periodontal attachment levels, periodontal health of teeth adjacent to the proposed implant sites, unrestorable caries, root fractures with large endodontic posts and questionable teeth in need of endodontic retreatment. The most esthetically challenging in implant placement is the maxillary anterior region. The reason being that tooth loss leads to resorption of bone and collapse in gingival architecture leading to esthetic compromise and inadequate bone for implant placement. Also, the advantages of placing Immediate implant into freshly extracted socket reduces the treatment time, cost, and increases the patient comfort. This case report describes the procedure for immediate implant placement in fresh extraction socket. Clinical and radiographic examination revealed width and length of the tooth for selecting implant size and design. Implant was successfully loaded and was functional during 24 months follow up period.

Ridge alterations after implant placement in fresh extraction sockets or in healed crests: An experimental in vivo investigation.

To study the early and late bone healing around implants placed according to a flapless immediate (test) or flapped delayed (control) implant surgical protocol. In eight beagle dogs, immediate and delayed implants were placed. Test and control implants were randomly assigned, and horizontal and vertical bone remodelling, as well as bone-to-implant contact (BIC), were assessed with histology at 2 and 8weeks. Teeth were used as negative controls. Similar results were attained in the two groups when the vertical resorption of the buccal bone crest was evaluated (approximately 0.5mm). On the other hand, a marked horizontal buccal bone resorption was observed. Immediate implants attained a thinner buccal bone crest as compared to the delayed implant and the tooth. De novo bone formation on the implant surface appeared to be more pronounced at delayed sites at 2weeks, whereas at 8weeks, no difference in BIC was observed. Ridge alterations occurred at both implant placement protocols, with similar limited amounts of vertical buccal bone reduction and a pronounced horizontal bone reduction. The process of horizontal bone remodelling differed between the two surgical protocols.

Implant placement in fresh extraction sockets.

Recent systematic reviews have shown that the survival rate of immediate implant placement is similar to those with a delayed approach. However, preclinical models and human studies have shown that immediate implant placement per se does not preserve the anatomy of the alveolus, mainly at the buccal bone crest, leading to bony dehiscences and subsequently to soft-tissue recession, with a great impact on esthetic outcomes. On the other hand, preclinical and human studies have identified factors that may prevent bone resorption after immediate implant placement, such as anatomical/biological (alveolus, gingival biotype, periapical/periodontal pathology) and surgical/restorative ones (implant diameter and positioning, flap/flapless, bone and connective tissue grafts, immediate loading/provisionalization, antibiotics). Taking these factors together and with a critical treatment plan made by an expert professional, the immediate treatment approach could be possible and beneficial for the patient.

Treatment trends in periodontics.

This volume of Periodontology 2000, entitled "Treatment Trends in Periodontics", evaluates the importance of nonsurgical periodontal therapy and defines its role as the key etiologic treatment of the disease. The need for scaling and root planing is mandatory step during the initial phase of therapy, as is self-care by the patient. Only after reevaluation of the outcome achieved by nonsurgical procedures should surgery be considered, and the concept of "critical probing depth" is emphasized. The chapters in this volume discuss different aspects of periodontal surgery, including regeneration and plastic periodontal procedures, and, looking toward the future, cell therapy in periodontics is explored. The impact of periodontal therapy on systemic diseases is reviewed, and the role of occlusion in periodontal disease is revisited and discussed. Topics on implants include their placement in fresh extraction sockets, socket healing with or without implant placement, and research on osseointegration. The important topic of maintenance care of teeth and implants for long-term therapeutic success is thoroughly evaluated, as is the efficacy of dentifrices in oral hygiene. The editors convey a nutshell review of the concepts of what periodontal treatment should entail, based on scientific evidence generated during half-a-century of work in periodontics.

Immediate implant placement in fresh extraction sockets using the open healing technique and tissue level implants

Immediate implant placement in fresh extraction sockets using the open healing technique and tissue level implants

A study to assess the bone formed around immediate postextraction implants grafted with Concentrated Growth Factor in the mandibular posterior region

Aim Extraction of the teeth and a healing period of 4-6 months followed by implant placement is a common procedure for the treatment of teeth with bad prognosis. This study was done to assess radiographically the quantity and quality of bone formed in the region of mandibular first molar after extraction of the tooth and immediate implant placement with Concentrated Growth Factor (CGF) grafting. Materials and methods A total of 10 subjects were selected for this prospective study. Extraction of mandibular first molars was carried out and implants were immediately placed with CGF grafting. A Cone Beam Computed Tomography (CBCT) was taken immediately after implant placement and after six months of undisturbed healing, radiographic evaluation was carried out using CBCT to assess the quantity and quality of new bone formed around implants. The collected data were statistically analyzed. Results CBCT results showed a mean bone gain of 2.3 mm in buccal, 1.52 mm in lingual, 2.97 mm in mesial and 4.26 mm in distal aspect respectively. No statistically significant change was noticed in bone density comparing the first two and last two threads of implants inserted with concomitant placement of CGF into the extraction socket. Conclusion This study indicates the possibility to perform immediate implant placement in fresh extraction sockets with the use of CGF as an alternative to conventional grafting. Further research needs to be carried out on the subject to validate the results obtained in this study.

The Effect of Platelet-Rich Fibrin on Soft Tissue and Crestal Bone in One-Stage Implant Placement in Fresh Extraction Sockets: A Randomized Controlled Clinical Trial

Introduction: The goal of modern dentistry is to prevent tooth loss and provide a healthy dentition with optimal functional efficiency, structural balance, and aesthetic harmony. The placement of an implant immediately after tooth extraction helps to maintain the bone crest and leads to ideal implant positioning from a prosthetic point of view and has the potential of decreasing the total treatment time for patients. Aim and Objective: To evaluate the platelet rich fibrin with or without bone ceramic on soft issue and crestal bone in one stage implant placement in fresh extraction socket. Materials and Methods: A total of 30 patients were randomly assigned into two groups—each group comprising 15 patients based on platelet-rich fibrin with and without bone ceramic and one-stage implant placement in fresh extraction socket. All patients were prospectively evaluated clinically and radiographically. All the data were analyzed using a software statistical package for social sciences (SPSS) version 11.5 (Chicago, Illinois, USA). Results: During the 6-month interval, no implant was lost; the mean bone level at the implants increased in platelet-rich fibrin (PRF) with bone ceramic group and decreased in PRF group and papillary index increased in both the groups, whereas modified sulcus bleeding index and probing pocket depth (PPD) decreased in both the groups. Conclusion: It can be concluded that mean crestal bone levels increased in PRF with bone ceramic group, whereas decrease in PRF group and both the groups are statistically significant. When the papillary levels are compared between the two groups, there was no statistical significance, but increased papillary levels were found in both the groups. The mean PPD was decreased in both the groups, but there was no statistical significance between the two groups.

Short, parallel-walled, conical-connection implants for a broad range of indications in the maxilla and mandible: Retrospective multicenter study with up to 33 months of follow-up.

To evaluate the survival and complication rate of 7-mm short, parallel-walled, conical-connection implants in daily practice. This multicenter retrospective study included 219 consecutive patients who received 323 implants. Indication was limited vertical bone height preventing placement of implants longer than 7 mm. Placement and loading protocols were determined on a case-by-case basis and included placement in fresh extraction sockets and healed sites, and loading was either immediate, early, or delayed. Patients were followed for up to 33 months. Outcome measures were implant survival rate and any biologic or technical complications. In total, eight implants in seven patients failed, accounting for the survival rate of 97.3% at implant level and 96.4% at patient level. The mean time to failure was 7.5 months and 10.2 months at the implant and patient level, respectively. The majority of patients (67.1%) received one implant and the placement was predominantly in healed sites (82.7%). Immediate loading was done for 21.4% of implants placed in the extraction site and for 21.3% of implants placed in healed sites. In most of the cases (71.8%) implants were placed in the premolar or molar position in the mandible. No complications were reported. These results suggest that in cases of limited vertical bone height, the short, parallel-walled, conical-connection implant can successfully support different prosthesis types in a wide variety of indications and loading protocols.

Soft-tissue esthetic outcome of single implants: Immediate placement in fresh extraction sockets versus conventional placement in healed sockets.

Background:Immediate implant placement has advantages such as requiring fewer surgical procedures and decreased treatment time; however, unpredictable soft- and hard-tissue outcome is a problem. This study aimed to compare the soft-tissue esthetic outcome of single implants placed in fresh extraction sockets versus those placed in healed sockets.Materials and Methods:This cross-sectional, retrospective study was performed on 42 patients who received single implants. Twenty-two patients with a mean age of 40.14 years received immediate implants while 18 patients with a mean age of 43.40 years were subjected to conventional (delayed) implant placement. The mean follow-up time was 14.42 ± 8.37 months and 18.25 ± 7.10 months in the immediate and conventional groups, respectively. Outcome assessments included clinical and radiographic examinations. The esthetic outcome was objectively rated using the pink esthetic score (PES).Results:All implants fulfilled the success criteria. The mean PES was 8.54 ± 1.26 and 8.10 ± 1.65 in the immediate and conventional groups, respectively. This difference was not statistically significant (P = 0.329). The two PES parameters, namely, the facial mucosa curvature and facial mucosa level had the highest percentage of complete score.Conclusions:Immediate and conventional single implant treatments yielded comparable esthetic outcomes.