Immediate implant placement in molar extraction sites: a 1-year prospective case series pilot study

Abstract

Background: There is a growing tendency to place single tooth implants immediately after extracting a failing tooth in the posterior region. The aim of this prospective case series pilot study was to evaluate immediate implant placement in molar post-extraction sites during a 1-year follow-up period. Materials and methods: Fifteen consecutive patients with a single failing molar in the maxilla or mandible, and presenting enough bone to expect primary implant stability and an implant site free of infection, were included. The implants, with a large thread depth and sharp thread edges, were placed in each patient according to a two-staged surgical procedure. Three months later, a full contour screw-retained zirconia restoration with an angulated screw channel abutment was provided. Clinical and radiographic examinations were performed 1 month and 12 months after placing the restoration. In addition, the patients' satisfaction with the restoration was scored after 12 months. Results: Four out of 15 of the mobile implants had to be removed before the 1-year evaluation. The implant and restoration survival rates were 73.3% at the 1-year evaluation (n = 15). The mean marginal bone loss, from loading to the 12-month follow-up, was 0.17 mm (n = 11). The mean plaque, calculus, peri-implant mucosa, bleeding, and pocket probing depth scores were low, depicting healthy peri-implant conditions. The patients were very satisfied. Conclusion: It was demonstrated, within the limitations of this study, that immediate placement of regular diameter implants in molar post-extraction sites in the maxilla and mandible resulted in a high implant failure rate during a 1year follow-up period.

Guidance and rationale for the immediate implant placement in the maxillary molar

“…Our study showed a 93.10% survival rate, which is higher than that of previous studies [8][9][10] . Such a successful outcome depends on primary stability of the implant with apical and lateral bone 4,20 .…”

“…The main challenge for this procedure is primary stability of the implant in the fresh socket. Several studies have discussed failure of immediate implant and its possible causes 8 - 10 . However, there is no guideline regarding proper case selection and surgical technique for successful immediate implant placement in the maxillary molar.…”

Management of Postsurgical Complication in Multiple Implant-Infected Postextraction Sites in the Lower Arch

“…However, it should be mentioned that most research on the immediate placement of implants after extraction is linked to the preservation of esthetic conditions, although this is less important in the posterior region [ 10 ]. Alveolar infection in the posterior sector is known to be a risk factor for dental implant failure.…”

Influence of Inter-Radicular Septal Bone Quantity in Primary Stability of Immediate Molar Implants with Different Length and Diameter Placed in Mandibular Region. A Cone-Beam Computed Tomography-Based Simulated Implant Study

“…[ 1 ] In postextraction sites, the anatomical morphology influences primary stability and osseointegration. [ 2 ] Factors such as bone quantity, quality, the surgical technique of implant placement, and geometrical factors of the implant including shape, length, and diameter have a definite influence on the primary stability of the implant. [ 3 ] Immediate implants placed in the anterior region are more stable than those in the posterior region as, molar teeth being multi-rooted and socket sizes exceed that of most current implant diameters; therefore, it is difficult to estimate the optimal primary stability in the posterior mandible.…”

“…[ 7 ] In mandibular molar teeth, where interradicular bone is insufficient in providing good primary stability, wider diameter implants may be preferred that can engage the perimeter wall of the molar sockets. [ 2 8 ]…”