Extraction and Immediate Placement of Implant by fanzhongqing

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									Extraction and Immediate
  Placement of Implant
            Introduction
The dental implants revolutionized the
practice of dentistry and have become a
successful, predictable treatment modality
in partially and fully edentulous patients
A healing period (6-12 months) after
extraction was considered one of the most
important factors for success of dental
implants
             Introduction
Several studies clearly demonstrated the
progressive alveolar bone atrophy
occurring after loss of teeth in all directions
The residual alveolar ridge might be
inadequate to insert dental implants
The insertion of dental implants into fresh
extraction sites provided a realistic
solution to overcome this problem
            Introduction
The most obvious advantages of
immediate dental implants are bone
preservation and reduction of treatment
time with relevant patients’ satisfaction
           Introduction
Immediate implant placement
Delayed implant placement
Staged implant placement
              Definition
Immediate implant placement occurs at
the time of extraction
Delayed implant placement is performed
approximately 2 months post-extraction to
allow soft tissue healing
Staged implant placement allows for
substantial bone healing within the
extraction site that typically requires 4-6
months or longer
Success rate 90-95%
Success rate 93.9% (Becker 1994)
            Advantages
Treatment time is reduced
Width and height of alveolar bone is
preserved
Enables the operator to achieve ideal
implant location mesiodistally and bucco-
lingually
Crown length is in harmony with the
adjacent teeth, natural scalloping and
distinct papillae are easier to be achieved
          Disadvantages
Unfavorable implant angulation due to
misalignment of the extracted tooth
Failure to achieve the critical element of
primary stability due to anatomical
considerations
Inability to perform primary closure
            Indications
Root fracture
Crown fracture
Endodontic failure
Severe decay
Unfavorable crown-root ratio
        Contraindications
Infected site (presence of purulent
exudate)
Insufficient depth for primary stability of
the fixture
Width of the extraction socket is less than
4-5 mm
Ideal extracted sites are:
1. 4 wall socket
2. 3 wall dehiscence type defect (5 mm or less)
   in apico-coronal direction
3. The osseous crest lies in the coronal 1/3 of
   the root to be extracted
4. Sufficient bone (4-6mm) beyond the apex for
   primary stability of the implant
              Problems
Prediction of bone level after healing is
difficult
Fixture position may be compromised
Difficulty of complete flap closure

								
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