ACCURACY OF TOOTH GUIDED IMMEDIATE IMPLANT PLACEMENT AT MOLAR REGION (CLINICAL TRIAL)

Document Type : Original Article

Authors

1 Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt

2 Professor of Oral and Maxillofacial Surgery Alexandria University, Alexandria, Egypt.

3 Assistant Professor of Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.

Abstract

INTRODUCTION: The concept of immediate implant placement has become popular due to reduced trauma and reduced overall treatment time. Removal of molar teeth provides a challenging and intriguing dilemma due to multiple root morphology. In cases of extraction and immediate placement of implants in the molar region, removal of the inter-radicular septum should be avoided to attain initial implant stability at the time of placement, and prevent slipping of the implant into the extraction socket. Following this technique prevents the slippage of the implant and allows the implant to be guided into the inter-radicular septum.
OBJECTIVES: To assess the accuracy of implant placement using the remaining roots of multi-radicular mandibular molars, evaluate bone density around implants and implant stability in fresh extracted site.
MATERIALS AND METHODS: A prospective study was done on 10 patients with badly destructed mandibular molars. The technique of implant insertion consisted of a progressive preparation of the implant site using the anatomy of the root of the multi-radicular mandibular molars to be extracted as a reference and as an aid to engage the inter-radicular septum. Implant stability was evaluated using Osstell; Radiographic evaluation was done by Cone Beam Computed Tomography.
RESULTS: Nine out of ten implants were functioning successfully along the evaluation period, while one implant failed 4 weeks after insertion and was removed. Clinically, implants stability was assessed using Osstell. All implants showed increase in ISQ value after 3 months. Radiographically, immediate postoperative CBCT was carried out which showed implants placed in ideal position. After 6 months, CBCT showed increase in bone density around implants compared to the immediate postoperative CBCT.
CONCLUSIONS: Tooth guided immediate implant placement at molar region is a novel technique for easy and safe implant insertion.

Keywords

Main Subjects

References

1. Schulte W, Heimke G. The Tubinger immediate implant. Die Quintessenz. 1976;27:17-23.
2. Botticelli D, Renzi A, Lindhe J, Berglundh T.Implants in fresh extraction sockets: A prospective5-year follow-up clinical study. Clin Oral Implants Res. 2008;19:1226-32.
3. Schwartz-Arad D, Laviv A, Levin L. Survival of immediately provisionalized dental implants placed immediately into fresh extraction sockets. J Periodontol. 2007;78:219-23.
4. Chen ST, Wilson TG, Jr., Hammerle CH. Immediate or early placement of implants following tooth extraction: review of biologic basis, clinical procedures, and outcomes. Int J Oral Maxillofac Implants. 2004;19 Suppl:12-25.
5. Moy PK, Nishimura GH, Pozzi A, Danda AK. Single implants indorsalareas –Asystematic review. Eur J Oral Implantol. 2016;9(Suppl 1):S163-72.
6. Scarano A. 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. Int J Oral Maxillofac Implants. 2017;32:655–60.
7. Rodriguez-Tizcareño MH, Bravo-Flores C. Anatomically Guided Implant Site Preparation Technique at Molar Sites. Implant Dent. 2009;18:393–401.
8. Barone A, Toti P, Quaranta A, Derchi G, Covani U. The Clinical Outcomes of Immediate Versus Delayed Restoration Procedures on Immediate Implants: A Comparative Cohort Study for Single-Tooth Replacement. Clin Implant Dent Relat Res. 2015;17:1114-26.
9. Atieh MA, Payne AG, Duncan WJ, de Silva RK, Cullinan MP. Immediate placement or immediate restoration/loading of single implants for molar tooth replacement: a systematic review and meta-analysis. Int J Oral Maxillofac Implants. 2010;25:401-15.
10. Peñarrocha M, Uribe R, Balaguer J. Immediate implants after extraction. A review of the current situation. Med Oral. 2004;9:234-42.
11. Tolstunov L. Dental implant success-failure analysis: a concept of implant vulnerability. Implant Dent. 2006;15:341-6.
12. Sotto-Maior BS, Rocha EP, de Almeida EO, Freitas-Júnior AC, Anchieta RB, Del Bel Cury AA. Influence of high insertion torque on implant placement: an anisotropic bone stress analysis. Braz Dent J. 2010;21:508-14.
13.Mahesh L, Kurtzman GM, Schwartz D, Shukla S. Residual roots as an anatomical guide for implant placement: case series with two-year follow-up. J Oral Implantol. 2016;42:285-8.
14. Joshi V, Suhag V, Gupta S. Multirooted tooth guided immediate implant placement in molar sites: A report of two cases. Int J Curr Res. 2017;9:44967-9.
15.Davarpanah M, Szmukler-Moncler S. Unconventional implant treatment: I. Implant placement in contact with ankylosed root fragments. A series of five case reports. Clin Oral Implants Res. 2009;20:851-6.
16.Valenzuela S, Olivares JM, Weiss N, Benadof D. Immediate implant placement by interradicular bone drilling before molar extraction: clinical case report with one-year follow-up. Case Rep Dent. 2018;2018:6412826.
17. Di Giacomo GA, Cury PR, de Araujo NS, Sendyk WR, Sendyk CL. Clinical application of stereolithographic surgical guides for implant placement: preliminary results. J Periodontol. 2005;76:503-7.
18.Rohra E, Mistry G, Joshi T, Khanvilkar U. Implant bed preparation for immediate implantation in molar region: An alternative approach. JDMS. 2017;16:48-50.
19.Rebele SF, Zuhr O, Hürzeler MB. Pre-extractive interradicular implant bed preparation: case presentations of a novel approach to immediate implant placement at multirooted molar sites. Int J Periodontics Restorative Dent. 2013;33:89-96.
20.Albrektsson T, Jansson T, Lekholm U. Osseointegrated dental implants. Dent Clin North Am. 1986;30:151-74.
21. Parithimarkalaignan S, Padmanabhan TV. Osseointegration: an update. J Indian Prosthodont Soc. 2013;13:2-6.
22.Douglass GL, Merin RL. The immediate dental implant. J Calif Dent Assoc. 2002;30:362-5,368-74.
23.Wagenberg BD, Ginsburg TR. Immediate implant placement on removal of the natural tooth: retrospective analysis of 1,081 implants. Compend Contin Educ Dent. 2001;22:399-404, 406, 408 passim; quiz 412.
24.Acocella A, Bertolai R, Sacco R. Modified insertion technique for immediate implant placement into fresh extraction socket in the first maxillary molar sites: a 3-year prospective study. Implant Dent. 2010;19:220-8.
25. Tarnow DP, Chu SJ. Human histologic verification of osseointegration of an immediate implant placed into a fresh extraction socket with excessive gap distance without primary flap closure, graft, or membrane: a case report. Int J Periodontics Restorative Dent. 2011;31:515-21.
26. Schwartz‐Arad D, Chaushu G. The ways and wherefores of immediate placement of implants into fresh extraction sites: a literature review. Journal of periodontology. 1997 Oct 1;68(10):915-23.
Alexandria Dental Journal
Volume 46, Issue 1
A (Oral and maxillofacial surgery, oral medicine, periodontology, oral radiology, oral pathology, oral biology)
April 2021
Pages 23-28

Files

Share

How to cite

Statistics