Within the limitations of the study, the Max implant demonstrated a survival rate of 95.7% and stable bone conditions after a year, irrespective of loading or surgical protocol. Future prospective studies are needed to evaluate the soft and hard tissue changes in time.

ObjectivesImplant placement in molar extraction sockets can be difficult due to complex multi-root anatomy and the lack of predictable primary stability. The aim of this study was to evaluate the outcome of an 8 - 9 mm diameter tapered implant, designed to be placed in molar extraction sockets.Material and methodsPatients treated at least 1 year before with a Max® implant (Southern Implants, Irene, South Africa) were invited for a clinical examination. Variables collected were surgical and prosthetic protocol, implant dimension and smoking habits. Peri-implant bone level was determined on peri-apical radiographs and compared to baseline, being implant insertion.Results98 implants had been placed in 89 patients. One implant had failed. Thirty eight patients representing 47 implants (maxilla 26, mandible 21) were available for clinical examination. Mean bone loss was 0.38 mm (SD 0.48; range - 0.50 – 1.95) after a mean follow-up of 20 months (range 12 - 35). Implant success was 97.9%. Around 30 implants, a bone substitute was used to fill the residual space, but this did not affect the bone loss outcome. Bone loss was only significantly different between maxilla and mandible (0.48 mm vs. 0.27 mm) and between the 8 and 9 mm diameter implants (0.23 mm vs. 0.55 mm). A full papilla was present at 71% of the interproximal sites and irrespective of bone loss.ConclusionsThe Max® implant demonstrated good primary stability, when placed in molar extraction sockets, with limited bone loss over time.

Background Although wide diameter implants are well documented, little is known about ultra‐wide diameter implants (>6 mm). This study evaluates the clinical outcome of ultra‐wide diameter implants, placed in molar extraction sockets. Materials and Methods Ultra‐wide diameter implants (7‐9 mm) were placed immediately after molar extraction in a 1‐stage protocol, without raising a flap or using any bone grafts. After 4 months, the implant was loaded with a single screw‐retained crown. Bone loss was evaluated using peri‐apical radiographs. Plaque and bleeding were recorded. Crown and papilla dimensions were measured and compared with the contra‐lateral tooth. Results Fifty‐one patients (36 male and 15 female), mean ages 61 years old, were treated with 26 implants in the maxilla and 25 implants in the mandible. The majority had a thick (#19) or medium (#31) biotype. After a mean‐follow‐up period of 23 months, the mean bone level was located 1.16 mm apical of the implant‐abutment junction (SD 0.42, range 0.00‐2.45) while the actual bone remodeling associated with socket healing resulted in a mean coronal movement of the bone level of 0.15 mm. The mean insertion torque was 116 Ncm (SD 53, range 10‐250). There were no differences in papilla height (P = .55), crown length (P = .32), zenith (P = .84), and bucco‐palatal dimensions (P = .38). There was a significant difference in the mesio‐distal dimension (P = .01). Mean probing depth was 2.59 mm at the implant and 2.23 mm at the contra‐lateral tooth (P = .001). There was significantly more plaque at the tooth compared to the implant (P = .01), but there was no significant difference in terms of bleeding on probing (P = .08). Patient satisfaction was high with 72.5% of the patients experiencing no problems at all. Conclusions Ultra‐wide diameter implants have a predictable outcome, demonstrating very little bone loss. Papilla and crown dimensions were comparable to the contra‐lateral natural tooth.

The aim was to evaluate ridge reduction and mucosal recession following immediate placement of ultra-wide implants in molar sockets, without bone grafting. Impressions were taken prior to tooth extraction, 4 months and 1 year after implant placement. The casts were digitized and compared. Mucosal recessions and horizontal ridge reduction were measured. A total of 16 implants were in the maxilla and 11 in the mandible. At the buccal aspect, there was a mean reduction of 0.94 mm after 4 months and 0.89 mm after one year (p = 0.933). At the palatal/lingual aspect, this was 1.09 mm after 4 months and 0.69 mm after 1 year (p = 0.001). After 1 year, a recession of 0.59 mm was measured at the zenith, 1.04 mm at the mesial and 0.98 mm at the distal papilla. The mean midfacial horizontal ridge reduction was 1.23 mm after 4 months and 1.45 mm after 1 year. At the midpalatal/midlingual aspect, the mean horizontal reduction was 1.43 mm after 4 months and 1.16 mm after 1 year. Immediate implant placement without bone grafting in the posterior jaw yields a significant horizontal ridge reduction and minor mucosal recession. Clinicians should anticipate the amount of ridge reduction and consider augmentation at the time of implant placement.