Replacement of teeth exhibiting periapical pathology by immediate implants. A prospective, controlled clinical trial

Abstract

It is concluded that for those implants where primary stability was achieved, the immediate implant placement performed at extraction sockets exhibiting periapical pathology did not lead to an increased rate of complications and rendered an equally favorable type of tissue integration of the implants in both groups. Implant placement into such sites can, therefore, be successfully performed.

Effect of PRF and Allograft Use on Immediate Implants at Extraction Sockets with Periapical Infection —Clinical and Cone Beam CT Findings—

“…Moreover, many studies have reported an increase in loss of endosseous implants at sites associated with periodontal disease 12,24,35) , whereas few have reported satisfactory results 13,20) . Similar success rates have been reported, however, with immediate implant placement whether the site was infected or not, provided infection was controlled thorough debridement of alveolar tissue by curettage and administration of broad-spectrum antibiotics 17,20,31,32,50,55) .…”

“…Hence, the presence of periapical infection should not be considered as a potential contraindication for immediate implant placement. Furthermore, human clinical studies have reported that implant survival rate ranged from 92 to 100% after 12 to 60 months of follow-up 13,17,20,31,32,50,55) . One study reported that the implant survival rate was 100%, and that hard and soft tissue integration was similar and favorable between the healthy and infected groups 18) .…”

“…A case of Pseudomembranous colitis was reported as a result of prolonged administration of antibiotics 13) . In other studies, postoperative administration of antibiotics was recommended 3,50,56) . In the present study, 1,500 mg amoxicillin per day was administered from 1 day preoperatively to 5 days postoperatively.…”

“…Although several antibiotic regimens have been proposed 39) , the evidence remains inconclusive. In some studies, clindamycin was administered at 600 mg at 1 hour preoperatively 31,50) , whereas in another 1.5 gm amoxicillin was given over a 4-day period preoperatively and then continued for 10 days postoperatively 13) . A case of Pseudomembranous colitis was reported as a result of prolonged administration of antibiotics 13) .…”

“…This entails a prolonged treatment period, however, which means that patient compliance is often poor 1) . Therefore, the majority of patients are interested in shortening the treatment time between tooth extraction and implant insertion 50) .…”