Immediate Implant and Customized Healing Abutment for a Periodontally Compromised Socket: 1-Year Follow-Up Retrospective Evaluation

Abstract

Immediate dental implant placement with or without immediate loading is reported in daily dentistry and implantology, but these procedures are not common in the case of periradicular and periapical lesions around the tooth needed to be replaced. In the following retrospective evaluation, 10 cases with a 1-year follow-up were selected to propose the technique of an immediate provisional non-loading prosthesis being delivered on the same day of the post-extraction implant placement in multiradicular teeth affected by chronic periradicular and periapical lesions. Post-extractive sockets underwent immediate dental implant placement by filling the empty space with sterile, re-absorbable gelatin sponges. The widths of the alveolar ridge were measured on three-dimensional radiographs before and after the operation, 4 and 12 months later. Non-parametric statistics were performed to compare the outcomes over time with a level of significance of 0.05. Comparing the preoperative cross-sectional images of cone beam computerized tomography (CBCT) scans to the postoperative ones, it was noted that changes in the crestal ridge width, ΔCW, (compared to baseline) were negligible and not clinically appreciable. However, while ΔCW at 4 months appeared to be negative (−0.17 ± 045 mm), crestal width at 12 months was at the same level as the baseline (ΔCW = 0.02 ± 0.48 mm), with a significant difference between 4 and 12 months (p-value = 0.0494). Immediate implant placement with an immediate non-loading provisional customized healing abutment of polyether-ether-ketone placed into the post-extractive sockets with asymptomatic and large chronic periapical and periradicular lesions could represent a further treatment strategy for patients’ rehabilitation and soft tissue preservation to replace a hopeless tooth.

Volumetric analysis on the use of customized healing abutments with or without connective tissue graft at flapless maxillary immediate implant placement: A randomized clinical trial

“…The use of a CAD/CAM technique to fabricate a perfectly adapted PMMA healing abutment is a growing subject but is almost limited to description of techniques and case reports in terms of scientific evidence (Ruales-Carrera et al, 2019;Thoma et al, 2019). This approach has been described as a beneficial solution that permits to reproduce precisely the contours of the root cervical area, maintaining and personalizing peri-implant tissues architecture during the healing phase (Menchini-Fabris et al, 2020). Also, they allow to reduce postoperative discomfort and morbidity by avoiding a second stage surgery for dental implant exposure.…”

Clinical analysis of the tooth-implant papilla for two narrow-diameter titanium-zirconium implants in the anterior area: prospective controlled clinical study

“…Therefore, the rehabilitation of the mandibular incisors and/or maxillary lateral incisors (MI/MxLI) is a challenge for clinicians. Immediate dental implants could be a good treatment choice, but this kind of surgery is not always possible [ 16 , 17 ].…”

Initial Development of an Immediate Implantation Model in Rats and Assessing the Prognostic Impact of Periodontitis on Immediate Implantation

“…Studies have shown that a history of periodontitis was associated with significant marginal bone loss, higher implant failure rates, and more complications, including peri-implantitis, in the immediate implantation [ 20 , 21 ]. However, some studies have indicated that successful osseointegration could occur when implants were placed at previously infected sites [ 22 , 23 ]. Furthermore, clinical studies were reporting no significant difference in the clinical success of immediate implantation between sites with or without pre-existing periodontitis [ 24 ].…”