Traditional Postextractive Implant Site Preparation Compared with Pre-extractive Interradicular Implant Bed Preparation in the Mandibular Molar Region, Using an Ultrasonic Device: A Randomized Pilot Study (original) (raw)
Related papers
Early and immediate implant placement with a root-analog implant design is a well established and proven protocol for placing dental implants. Results of more than 25 years of clinical and statistical data indicate that predictable long-term success can be achieved 1,2 . Moreover, immediate placement offers significant benefits to both the patient and the clinician. The number of surgeries is minimized and overall treatment time is shortend. Width and height of the alveolar bone is preserved, an a better implant location results in maximal function and esthetic soft tissue support.
Egyptian Dental Journal
Placement of immediate implant in mandibular molar area is considered a great challenge, due to the difficulty of implant bed preparation in the presence of interradicular bone septa. Therefore, this study introduces a simple technique for implant bed preparation. Objectives: This study aimed to compare clinically and radiographically the effect of performing two different surgical approaches for implant bed preparation. Materials and Methods: A randomized, controlled clinical trial was conducted on twenty six adult patients equally divided between a study group; where an immediate implant was installed following an innovative drilling protocol through drilling in the inter-radicular bone preceding molar extraction and a control group; where an immediate implant was installed conventionally after molar extraction. Clinical evaluation included assessing implant stability quotient (ISQ) at base line and after 6 months. While radiographic evaluation was done through periapical X-ray and CBCT to assess the implant position and marginal bone loss around the installed implants at baseline and after 6 months. Results: Clinical results revealed that there was no statistical significance difference in mean average ISQ between both groups at base line and after 6 months. Regarding the radiographic results the study group showed that the paralleling pin was more centrally oriented within the interradicular bone in comparison to control group. Concerning the marginal bone loss there was no statistical difference between the two groups. Conclusion: The implant bed preparation before roots extraction allows optimal positioning and angulation of the immediate implant in mandibular molar area, thus enabling ideal future prosthesis.
Journal of Craniofacial Surgery, 2018
Background: Immediate implant insertion in mandibular molar extraction sockets raises a series of challenges for clinicians. Purpose: This preliminary study demonstrates the use of a modified insertion technique of implant placement at the time of mandibular molar extraction. Materials and Methods: Immediate implants were placed at the time of molar extraction in 20 patients; a sulcular buccal incision with releasing periosteal incisions were made around the mandibular molar to be replaced, and implant insertion into the interseptal/interradicular bone was performed. The remnants of roots were atraumatically extracted, and the bony defects around the implant were grafted with synthetic resorbable bone substitute β-Tricalcium phosphate, and the flap was sutured. Three months later, implants were restored with single crown fixed prostheses. Patients were followed up at 6, 12, and 18 months after insertion using periapical standardized radiographs to monitor the changes in the marginal bone level. Results: Our modified insertion techniques showed an implant survival rate of 95%; one implant failed 4 weeks after insertion. No significant marginal bone loss around the implant was recorded at all times of follow-up. Satisfactory soft issue parameters were achieved. Conclusions: The combination of immediate implant placement with engagement of the interseptal/interradicular bone, atraumatic extraction of remnant roots, and concomitant regenerative therapy showed preliminary favorable outcomes. However, wider application of this technique for longer following up periods is required for further conclusive recommendations.
Root Guided Immediate Implant Placement at Mandibular Molar Site: A Case Report
Journal of Nepalese Prosthodontic Society
With the advancement in science and technology, Immediate implant placement has become a widely used and well accepted alternative to traditional treatment protocols. Post extraction implant placement in multicoated molar area is challenging. The primary stability in molar areas is achieved by engaging the interradicular bone but slipping of osteotomy drill to mesial or distal root socket during implant bed preparation is the main problem in post extraction immediate implant placement. Use of surgical guide, pre- extractive interradicular implant bed preparation and the combination of both these techniques has been used to overcome the problem related to immediate implant placement at molar sites. This paper presents an alternative approach in immediate Implant placement in multi rooted molar area that uses the anatomy and morphology of roots in guiding the osteotomy to provide an ideal3-dimensional implant positioning.
Biomimetics, 2022
Ten years ago, for the first time in humans, thanks to the DLMS (direct metal laser sintering) technique, we designed, built and inserted an immediate post-extraction custom-made root-analogue implant in Ti-6Al-4v with platform switching. The implant was inserted into the post-extraction socket, respecting the biological width. After 10 years, we wanted to evaluate the dimensional stability of the implant and the eventual crestal bone resorption. The evaluation was performed clinically with periodontal parameters and radiographically by means of an intraoral X-ray with the parallel technique measuring the distance between the base of the bone crest and the implant shoulder. It appears that the implant has maintained dimensional stability of the peri-implant soft tissues, and the crestal resorption is 0 mm. This could represent a step forward to make this experimental method a valid alternative to the current immediate post-extraction implant procedures in use.
The International Journal of Periodontics & Restorative Dentistry, 2014
This multicenter case series introduces an innovative ultrasonic implant site preparation (UISP) technique as an alternative to the use of traditional rotary instruments. A total of 3,579 implants were inserted in 1,885 subjects, and the sites were prepared using a specific ultrasonic device with a 1-to 3-year follow-up. No surgical complications related to the UISP protocol were reported for any of the implant sites. Seventy-eight implants (59 maxillary, 19 mandibular) failed within 5 months of insertion, for an overall osseointegration percentage of 97. 82% (97.14% maxilla, 98.75% mandible). Three maxillary implants failed after 3 years of loading, with an overall implant survival rate of 97. 74% (96.99% maxilla, 98.75% mandible).
Partial Extraction Therapy for Implant Placement: A Newer Approach in Implantology Practice
Cureus
One of the most popular treatment modalities in routine implantology practice is extraction followed by immediate or delayed implant insertion. Teeth removal alone is insufficient, particularly in the maxillary anterior region of the jaw. Patients may experience several issues after tooth extractions. Due to trauma and the loss of periodontal ligaments, post-extraction alveolar ridge resorption cannot be prevented. Atraumatic extraction, socket preservation, grafting, and implant placement immediately after the extraction are some of the procedures that are carried out to minimize or prevent the resorption of alveolar bone. Osseointegration is essential for keeping the clinical effectiveness of dental implants. If the supporting tissues at an implant site resorb and are worsened by risk factors for recession, there may be considerable esthetic and functional failure. Implant placement at the retained root structure preserves the buccal bone resulting in an excellent emergence profile. Resorption in the posterior alveolar ridge may result in a decrease in attached keratinized tissue and a decrease in vestibular depth. This might have a negative impact on the stability of the implant and leads to peri-implantitis resulting in the failure of the implant. Without papilla loss or arch collapse, partial extraction therapy has resulted in effective esthetic outcomes. The socket shield technique is a minimally invasive surgical procedure that helps to maintain both soft and hard tissues by preserving a small section of the root. It lessens the necessity for surgeries on bone and mucogingival grafts, cutting the length of the overall recovery process and reducing the treatment time. When soft and hard tissue grafts are used to fill the socket before applying pressure with pontics, it is known as the pontic shield procedure. However, there is no published study that explains partial extraction therapy in a straightforward and clear manner that can guide a practitioner in determining a shield design with a proven track record of success. This review article focuses on the partial extraction procedure which is very helpful for preserving soft and hard tissues in cases involving immediate implant insertion postextraction. It has long-term therapeutic success with implant and pontic therapy. This review article will also be helpful for clinicians to understand shield design in different case scenarios and help to learn stepwise procedures carried out in partial extraction therapy.
Classification of molar extraction sites for immediate dental implant placement: technical note
The International journal of oral & maxillofacial implants
Dental implants may be successfully placed immediately into fresh extraction sockets when primary implant stability can be attained. This article presents a new classification system for molar extraction sites that describes extraction sockets based upon the bone available within the socket for stabilization of an immediately placed implant. Three categories--types A, B, and C--are employed: the type A socket, which allows for the implant to be placed completely within the septal bone, leaving no gaps between the implant and the socket walls; the type B socket, which has enough septal bone to stabilize but not completely surround the implant, leaving gaps between one or more surfaces of the implant and the socket walls; and the type C socket, which has little to no septal bone, thus requiring that the implant engage the periphery of the socket. Treatment protocols and relevant clinical examples are presented based upon the characterization of the socket according to this classificat...