Management of an Immediate Implant Horizontal Defect Using Freeze‐Dried Bone Allograft and a Neodymium:Yttrium‐Aluminum‐Garnet Laser

Abstract

Introduction: A contemporary protocol for managing horizontal alveolar defects adjacent to immediate implants includes placement of a well‐designed provisional restoration to contain graft material and seal the socket. However, immediate provisionalization is not always possible or practical. Case Presentation: A 39‐year‐old male presented with a non‐restorable tooth #29, which was extracted. An immediate implant was placed in the tooth #29 position, and a freeze‐dried bone allograft was placed in the horizontal defect between the implant platform and osseous walls. A neodymium:yttrium‐aluminum‐garnet (Nd:YAG) laser was used to create a stable fibrin clot over the graft material. After 31 months, favorable radiographic bone levels and complete papilla fill were noted. Conclusion: The present case illustrates use of an Nd:YAG laser in the management of an immediate implant horizontal defect in lieu of an immediate provisional restoration.

The Extraction Socket Management Continuum: A Hierarchical Approach to Dental Implant Site Development

“…Multiple approaches to immediate implant placement have been advocated . The protocol described by Chu and colleagues minimizes trauma to peri‐implant tissues and is capable of producing excellent clinical outcomes with limited postoperative discomfort .…”

Adjunctive Nd:YAG Laser Irradiation for Ridge Preservation and Immediate Implant Procedures: A Consecutive Case Series

“…Erbium, chromium‒doped: yttrium, scandium, gallium, garnet (Er,Cr:YSGG, 2,780 nm) and neodymium‒doped: yttrium, aluminum, garnet (Nd:YAG, 1,064 nm) lasers have been used clinically in conjunction with immediate implant placement . ‒ These lasers have very different absorption profiles and thus dissimilar intended purposes in immediate implant procedures.…”

“…The ensuing thermal denaturation of proteins produces a robust coagulation layer along the lased surface . Nd:YAG laser energy has been used at an immediate implant site to facilitate containment of freeze‐dried bone allograft (FDBA) particles within a peri‐implant gap defect …”

“…have been used clinically in conjunction with immediate implant placement. [1][2][3][4] These lasers have very different absorption profiles 5 and thus dissimilar intended purposes in immediate implant procedures. Er,Cr:YSGG laser output is highly absorbed in hydroxyapatite, allowing efficient cutting of hard tissue.…”

“…5 Nd:YAG laser energy has been used at an immediate implant site to facilitate containment of freeze-dried bone allograft (FDBA) particles within a peri-implant gap defect. 1 A third laser type has been evaluated for possible beneficial effects in peri-implant bone. In a rabbit model, gallium-aluminum-arsenide (GaAlAs, 830 nm) diode laser irradiation produced greater bone-to-implant contact (BIC) compared with non-irradiated controls.…”