A staged approach of implant placement in immediate extraction sockets for preservation of peri-implant soft and hard tissue

Abstract

Esthetic zone restoration is a challenging aspect in implant dentistry because of two critical factors such as level of bone support and soft tissue dimensions. Preservation of healthy peri-implant tissues is of primary importance for ensuring better esthetics over an extended period. The aim of the present case-series was to evaluate a new staged approach of implant placement in immediate extraction sockets for preservation of peri-implant soft and hard tissues. Four subjects scheduled for extraction of teeth in the esthetic zone with neither a periapical nor periodontal infection and with thick tissue biotype were included. For all the subjects sand blasted, large grit, acid etched platform switched implant with a diameter 2 mm less than the diameter of extraction socket and a conical abutment-implant connection (Morse taper) were placed 2 mm below the crest of the socket, with almost 2 mm gap between the labial plate and the implant with shoulder placed palatally/lingually. The implants were loaded after 2 months healing period and followed for a period of 1-2 years. In all the four patients there was preservation of both hard and soft tissues around the implant with a good esthetic outcome in all the follow up visits. Integrating immediate placement with stable implant-abutment connection, platform switching concept and careful case selection, we can achieve a very good esthetic outcome.

Immediate Implant in The Esthetic Zone: A Three Year Clinical, X-Ray and CBCT Follow-Up of Peri-Implant Tissues

“…The contact between enamel and cementum of the provisional restoration with the gingiva may promote better adaptation and tissue response to healing, in contrast with the more porous surface of the type of acrylic used to manufacture provisionals over implants. Despite the quality of the dental tissue remaining in the veneer, the rest of the provisional was carefully manufactured using bisacrylic resin, which ensured high quality polishing and smoothness and facilitated the adaptation of all peri-implant system [3,4,6,12,18].…”

“…The crown of the natural teeth may be an option for this stage, particularly because, in addition to smoothness of natural enamel, it has a more harmonious profile because, preserves the anatomy and provides better gingival sealing than the acrylic provisionals conventionally used [16,17]. Another factor is the preservation of enamel characteristics and the remaining root covered by cementum in the cervical portion of the natural teeth veneers, which have biological characteristics that may adapt more physiologically to the soft tissues of the gingiva than synthetic materials [1,16,18].…”

Efeito da laserfototerapia na reparação de osso alveolar humano: análise microtomográfica e histomorfométrica

“…Tem sido proposto que a instalação de implante em alvéolos frescos tem muitas vantagens, sugerindo que este procedimento pode neutralizar a modelagem do tecido que ocorre após a remoção do dente, portanto, preservar as dimensões do rebordo, com benefício estético, menor número de sessões e períodos de tratamento mais curtos (Penãrrocha et al, 2002;Vinnakota et al, 2014).…”