Clinical Significance of Immediate Implant Placement
The immediate implant placement offers a considerable advantage over other treatment modalities. This procedure has many clinical benefits such as the reduction of surgical interventions, the shortening of total treatment period, and the save of total treatment cost. However, it is not easy to place the implants into the fresh extraction sockets, because the geometric discrepancy between extraction socket and implant design might make it difficult to gain the initial fixation which is one of the most important factors for successful implant placement. Therefore, whether or not it would be successful depends on the case selection of immediate implant placement. The goal of this paper is to discuss the important factors for successful immediate implant placement and try to find a preferable case selection.
Patients and Methods
From September 2007 to November 2013, 12 patients ( male 7, female 5) who received immediate implant placement in our clinic. AQB apatite coated implant system (Advance Co. LTD, Tokyo, Japan) was employed in this study. The implant sites were distributed over anterior and premolar area in both the Maxilla and the Mandible. A total of 12 implants were placed immediately after teeth extractions without any bone augmentation procedures.
Results
There were no implant failures in this study, although the follow-up period included the limited short period such as 4 months after the implant placement. In the case of maxillary lateral incisor, slight labial gingival recession was observed after implant placement. In the case of mandibular central incisor, it was seemed that the initial fixation was not sufficient. In contrast, there were no clinical significant problems in other cases.
Conclusions
The labial gingival recession of maxillary anterior area seems to occur due to too thin labial alveolar bone. To reduce the risk of gingival recession, the implants should be placed more palatally in the extraction socket rather than the ordinary central position.
The insufficient initial fixation of mandibular anterior area might occur with the geometric discrepancy between extraction socket and implant design. Against the insufficient initial fixation, the reinforcement using wire fixation was adopted and the preferable osseointegration was established. Among various implant sites, the premolar area appeared to be the most preferable site for immediate placement, because the shape of extraction socket was most likely to be similar to implant design and the bone volume is relatively rich, although it was possible to perform immediate placement in other areas.
References
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2)Papalexiou V, Novaes AB Jr, Grisi MFM, Souza SSLS, Taba M Jr, Kajiwara JK. Influence of implant microstructure on the dynamics of bone healing around immediate implants placed into periodontally infected sites. A confocal laser scanning microscopic study. Clin. Oral Impl. Res. 15, 2004 ; 44-53.