A prospective, controlled clinical trial evaluating the clinical radiological and aesthetic outcome after 5 years of immediately placed implants in sockets exhibiting periapical pathology

Abstract

OBJECTIVE: The aim was to compare the clinical, aesthetic and radiological outcome of immediately placed implants in sockets with or without periapical pathology 5 years after placement. MATERIALS AND METHODS: Twenty-seven patients were followed 5 years after immediate implant placement (test-group: 12 patients with periapical pathologies; control-group: 15 patients without periapical pathology). Clinical (FMBS, FMPS, CAL, keratinized mucosa), aesthetical (length of clinical crown, Papilla index), and radiological (vertical distance implant shoulder to first bone to implant contact (IS-BIC)) parameters were assessed. Both 95% confidence intervals, as well as results of statistical tests (one-sample, two-sample, paired t-test) were provided. RESULTS: After 5 years the implant survival rate was 100% for all 27 implants. In the test group the width of the keratinized mucosa increased significantly over the observation period (0.8 ± 1.0 mm). Concerning aesthetic parameters at the 3-month as well as at the 5-year examination no statistically significant difference could be found between the two groups. In the control-group the papilla mesial and distal to the implant increased statistically significant during the observation period by 0.5 ± 0.5 and 0.4 ± 0.6 index score points, respectively. The position of the gingival margin at the implant site and the two neighboring teeth remained stable. At the 5-year visit IS-BIC measured between 1.4 ± 0.5 mm (mesial, control) and 1.7 ± 0.7 mm (distal, test), no significant difference could be found between the two groups. Over the observation period no statistically significant change of IS-BIC could be found in the test-as well as in the control-group. None of the examined radiographs revealed any signs of retrograde peri-implantitis. CONCLUSION: The replacement of teeth exhibiting periapical pathologies by implants placed immediately after tooth extraction can be a successful treatment modality with no disadvantages in clinical, aesthetical and radiological parameters to immediately placed implants into healthy sockets.

Bone volume changes after immediate implant placement with or without flap elevation

“…Ridge preservation procedures, originally intended to maintain bone volume after tooth extraction, have also shown some reduction in height and width . Jung et al (2013) using CBCTs showed a mean horizontal reduction of 0.6mm and a vertical reduction from 0.0 to 1.2mm at extraction sites filled with anorganic bovine bone with no flap elevation at 6 months of healing. Similarly, the results of this investigation show that immediate implant placement with simultaneous bone grafting does not entirely avoid bone resorption.…”

“…Placing immediate implants on sites with previous periapical pathologies has been a concerning issue but some recent studies have shown similar survival rates to those implants inserted in healthy areas (Jung et al 2013;Lindebom et al 2006). Hence, survival rates of 92-100% were reported in a recent systematic review (Corbella et al 2013).…”

“…The 3D reconstructions of both CBCTs were superimposed using Simplant Pro ® 2011 (Dentsply Spain, S.L.) according to the technique described by Jung et al (2013). At least three anatomical reference points were established on each 3D image in order to match CBCT1 and CBCT2 (Figure 3).…”

Immediate implant placement in the infected sockets - A case series

“…The result reflects and confirms the hypothesis that endosteal implants can be successfully integrated in infected sites. However, alveolar ridge resorption after the tooth extraction is a frequent occurrence and may significantly reduce the residual bone volume [23][24][25][26][27][28]. This study is a proof of principle that sockets can heal naturally with immediately placed implants in infected sites and tissue shrinkage can be reduced by utilizing least invasive surgical and prosthetic protocol.…”

Reproducibility of Buccal Gingival Profile Using a Custom Pick‐Up Impression Technique: A 2‐Year Prospective Multicenter Study

“…Nowadays, the replacement of single and multiple gaps in partially edentulous patients by means of dental implants is a predictable clinical procedure . Nevertheless, for patients undergoing single implant treatment in high‐demanding areas, the esthetic outcome may be more difficult to achieve.…”