Laser Therapy for Infected Sites and Immediate Dental Implants in the Esthetic Zone: A Case Report and Review of Literature

Abstract

Placement of postextraction dental implants has become a common practice. Here, we reviewed current literature, along with clinical procedures, outcomes, and incidence of complications, associated with immediate implants in infected postextraction sites. The YSGG (yttrium, scandium, gallium, and garnet) laser can significantly reduce the bacterial concentration after extracting a compromised tooth. We treated a 40-year-old woman with a compromised tooth in the esthetic zone, presenting clinical and radiological signs of infection, particularly a periapical periodontitis. The tooth was extracted after administering local anesthesia using Optocain® (mepivacaine and adrenalin 1 : 100,000), following which the site was treated with an ErCr : YSGG (erbium, chromium-doped yttrium, scandium, gallium, and garnet) 2780 nm laser device (Biolase iPlus®). The implant (Straumann® fixture) was inserted with minimum 35 N torque, 1 mm below the most apical bone peak. Bio-Oss® and resorbable membrane were applied to improve bone healing. The use of ErCr : YSGG laser has ensured success of implant therapy performed on an infected site. There were no complications such as peri-implantitis or loss of peri-implant bone. The implant achieved good primary stability, immediate placement into an infected site did not increase complications, and the 5-year follow-up confirmed the treatment success.

Immediate dental implant placement in post-extraction-infected sites decontaminated with Er,Cr:YSGG laser: a retrospective cohort study

“…There are some drawbacks, such as the device's price. A review of the trials on the topic shows that immediate dental implants into contaminated sites do not raise the rate of problems or impede tissue integration, as long as correct clinical protocols are followed to obtain a good alveolus cleaning [31].…”

Conservative Therapy of External Invasive Cervical Resorption with Adhesive Systems: A 6-Year Follow-Up Case Report and Literature Review

“…Even if the efficacy of Biodentine and MTA is widely demonstrated, in this case report, composite resin (Filtek™ Universal Restorative, 3M Company) was preferred. Both the "white" and "pink" aesthetics of a smile are complex to imitate, especially if there is an impairment of the dental and periodontal tissues that entail the risk of losing a tooth in the aesthetic area [21]. However, modern composite resins offer a very satisfactory degree of integration when it is possible to restore the natural tooth.…”

Implant Periapical Lesion: A Narrative Review

“…Meticulous cleaning, thorough debridement/ curettage, and chemical irrigation (such as 0.12% chlorhexidine) prior to implant placement could improve implant survival rate at infected sites [18,83,84]. Currently, lasers, including Er-Cr:YSGG and Nd:YAG Laser, are used as adjuncts for the debridement after extraction, especially during immediate implant placement [85]. Laser has been demonstrated to be superior to chemical treatment [85].…”

“…Currently, lasers, including Er-Cr:YSGG and Nd:YAG Laser, are used as adjuncts for the debridement after extraction, especially during immediate implant placement [85]. Laser has been demonstrated to be superior to chemical treatment [85]. To alleviate concerns of IPL, it may be helpful to decontaminate the socket after tooth extraction and to sterilize the site before implant placement with laser.…”