Topic: Basic research

Immediate implant placement and immediate restorationGalina Ciobanu,Chisinau, Moldava

Immediate implant placement and immediate restorationGalina Ciobanu,Chisinau, Moldava

AbstractAbstract

Case descriptionCase description

ConclusionConclusion

Immediately implant placement of dental implants in fresh extraction sockets has proven to be a predictable and successful procedure. The following case shows a case of a 35 year old patient who demanded a fast solution for his tooth which had to be extracted. After careful examination and the explanation with the involved risks he agreed to an immediate implant placement with an immediate rehabilitation with a resin crown on a temporary abutment.

The surgical procedure was performed under local anesthesia using articaine and 1:100.000 epinephrine (ubiseine, 3M, ESPE). The tooth was carefully luxated and extracted. The extraction socket washed with the antiseptic cefazolin.

Afterwards bredent SKY implant (diameter 4 mm, length 16 mm) has been placed immediately with a flapless procedure. The bone defects around the implant were filled with oss.ceram and covered with angiopore membrane, which was placed also above the implant.

With SKY temp the position and angulation of the implant has been controlled.

For three days for the healing and lining of the gum a gingiva former has been in place.

On the third day the ginviva former has been removed and the impression was taken in the open tray technique. The provisional crown has been produced in the lab on a SKY temp M abutment with the visio.lign system. The provisional restoration was bonded to the adjacent teeth to control the load on the implant during healing. After 3 month the implant is now stable osseointegrated. The soft tissue healing is already is favorable regarding the contour and the papilla. Nevertheless there are some scares visible caused by the infection.

The classic treatment protocol includes a healing period of several month after tooth extraction, the surgical placement of implants and another healing period of 3 to 6 month, but in conditions with sufficient primary stability Implants can be placed in sites with periapical and periodontal infections. The sites must be thoroughly debrided before placement. Guided bone regeneration is usually performed to fill the gap in the bone-implant and/or socket deficiencies. Although controversial, systemic antibiotics should be used locally and also systemically.

A lateral maxillary incisor presented pain and mobility. The clinical examination see a small vestibular inflammation, radiographic examination revealed tooth fracture with previous root canal treatment and restored with composite.

We expect that the scars are going to be diminished over time.