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

Abstract

Introduction: Correctly managed, immediate implant placement into fresh extraction socket is a favorable treatment option in order to reduce the overall treatment time and to increase the patient's comfort and satisfaction. Methodology: Atraumatic extractions (N = 42) with socket preservation were performed in n = 40 patients (0.74 sex ratio) followed by immediate placement of tissue level implants. Post extraction sockets were filled with either platelet-rich growth factors (PRGF) clots, or deproteinized bovine bone granules, or both; then covered by collagen resorbable membrane or cyanoacrylate and left exposed during healing. The pre-loading need for additional augmentation was assessed clinically and radiologically, using CBCT scans at t = 6 months. The success and survival rate were evaluated by control CBCT scans at a 4 year follow-up. Results: This analysis showed that "open healing" technique allowed uneventful healing and sufficient bone formation in combination with immediate placement of soft tissue level implants, a survival rate of 100% and a success rate of 95.2% at a 4 yr follow-up. There were no significant differences regarding crestal bone level stability around the implants with the different augmentation materials. Conclusion: Immediate placement of tissue level implants in fresh post extraction sockets using "open healing" approach can be favorable from both a clinical and radiological point of view considering the results at 4 years. In addition, soft-tissue problems associated with extensive flap mobilization and tension may be avoided and the 3D architecture of hard and soft tissues surrounding the implant may be maintained due to the tissue level implants design in accordance with the biological width when restored.

Open Healing: A Minimally Invasive Protocol with Flapless Ridge Preservation in Implant Patients

“…The minimally invasive technique that we described provides the necessary conditions for optimal healing in post-extraction sockets, regardless of the number of walls surrounding the bone defect, the evaluation of bone quality during treatment planning however being mandatory [ 22 ].…”