Immediate implant placement in molar regions: risk factors for early failure

Abstract

Implants placed immediately after extraction of a molar were associated with a high risk for failure at abutment operation. There was no difference in failure rate between three bone reconstructive techniques.

Immediate implant placement in molar regions: a 12‐month prospective, randomized follow‐up study

“…The attempt for a time save should always be balanced against a possible higher risk for implant failure or a higher risk for compromised peri‐implant bone and soft‐tissue status as stated in a recent article (Urban et al. ).…”

Novel Implant Design Improves Implant Survival in Multirooted Extraction Sites: A Preclinical Pilot Study

“…In agreement with the present findings, Liñares et al, 21 in a similar model that lacked augmentation procedures, found a relatively high degree of bone loss around immediate implants, ranging from 2.5 to 2.6 mm from implant shoulder to bone crest and 3.2 to 2.8 mm from implant shoulder to first BIC. On the contrary, radiographic bone loss of a much lesser extent (1.1 mm on average) was reported by Urban et al, 22,23 who compared different augmentation techniques in conjunction with immediate implantations in molar extraction sites.…”

Guidelines for Optimizing Outcomes with Immediate Molar Implant Placement

“…Clearly with the non-submerged approach the quantity and quality of keratinized gingival tissue will be a factor requiring consideration. Even with submerged IMI placement, there can be a risk of infection if dehiscence of the overlying soft tissues occurs during site healing [6]. Most investigators do not, however, include the incidence of periimplantitis causing IMI failure whether that is early or late [35].…”

“…Based on current literature, the following IMI placement guidelines are recommended:non-smokers only 2. a pre-op CBCT scan to minimize risk especially in mandible 3. thick gingival biotype and adequate keratinized tissue width (≥2 mm) 4. atraumatic extraction with flap-less surgery if feasible 5. only sites with intact socket walls after extraction 6. osteotomy preparation will vary with socket type (Table 1) 7.…”

“…Likewise, not all molar sockets will be appropriate for IMI placement thereby making careful case selection crucial. Patients should be non-smokers since smokers have been shown to have 10x the risk of IMI failure as non-smokers [6]. Other patient contraindications include history of head and neck radiation in the previous 12 to 24 months [7], uncontrolled diabetes [8], use of anti-resorptive [9] or RANK ligand-inhibiting [10] drugs, and parafunctional habits such as bruxism [11].…”