Editorial
The insertion of dental implants immediately after teeth extractions has become a routine clinical procedure in implant dentistry. This treatment modality has received much attention and has shown favorable results [1-4]. Several studies have reported that successful osseointegration is possible when implants are inserted immediately after tooth extraction, with similar survival rates when compared to implants inserted in healed sites with or without augmentation procedures [5-9]. Placing an implant immediately after tooth extraction offers several advantages, including a decrease in rehabilitation treatment time, fewer surgical sessions, the ability to place the fixture in an ideal axial position and positive psychological impact on the patient [10,11]. Another advantage of implant placement in the extraction socket is the counteracting of the hard tissue resorption that occurs following tooth extraction [12,13]. However, there are some topics as esthetic outcome and preservation of alveolar process, are still matter of debate [14]. In animal and human studies, it was shown that immediate post extraction implant placement failed to prevent the natural bone resorption that occurred in the socket walls and especially in the buccal wall [15]. It was also shown that this bone remodeling resulted in a marked reduction of the residual ridge dimension and occurred in the first months after tooth extraction [16]. Gordon L. Douglas stated that immediate implants ought to have 3- and 4-walled sockets, minimal periodontal bone resorption, sufficient bone to stabilize the implant, and minimal circumferential defects [17]; however in a prospective clinical study, Schropp et al. [18] observed that both delayed and immediate approach resulted in statistically significant reduction in bony defects. Other study observed less bone resorption around immediate implants compared to delayed implants [19]. The experiment of Caneva et al. [20] installed immediate implants into extraction sockets in the mandibles of six dogs and concluded that implants should be positioned approximately 1 mm below the alveolar crest and in a lingual position in relation to the center of the alveolus to reduce or eliminate the exposure above the alveolar crest of the endosseous rough portion of the implant. From the above mentioned findings, there is still need to perform further case–control studies and possibly randomized studies with large sample sizes in order to confirm the beneficial effects of immediate dental placement into fresh extraction sockets.
References
2. Anneroth G, Hedström KG, Kjellman O, Köndell PÅ, Nordenram Å. Endosseus titanium implants in extraction sockets: an experimental study in monkeys. International Journal of Oral Surgery. 1985 Feb 1;14(1):50-4.
3. Casap N, Zeltser C, Wexler A, Tarazi E, Zeltser R. Immediate placement of dental implants into debrided infected dentoalveolar sockets. Journal of Oral and Maxillofacial Surgery. 2007 Mar 1;65(3):384-92.
4. Paolantonio M, Dolci M, Scarano A, d’Archivio D, Di Placido G, Tumini V, et al. Immediate implantation in fresh extraction sockets. A controlled clinical and histological study in man. Journal of Periodontology. 2001 Nov;72(11):1560-71.
5. Al Nashar A, Yakoob H, Eizouki A, Khlily H. Evaluation of the Use of Plasma Rich in Growth Factors with Immediate Implant Placement into Fresh Extraction Sockets: A Controlled Prospective Study. IOSR Journal of Dental and Medical Sciences 2016;15:55-60.
6. Al Nashar A, Yakoob H. Evaluation of the use of plasma rich in growth factors with immediate implant placement in periodontally compromised extraction sites: a controlled prospective study. International Journal of Oral and Maxillofacial Surgery. 2015 Apr 1;44(4):507-12.
7. Ahmad Al Nashar, ( 2016). Evaluation of marginal bone loss around immediate dental implants with synthetic Hydroxyapatite graft: A prospective controlled study”, International Journal of Current Research. 8, (06), 32707-32714.
8. Becker W. Guided tissue regeneration for implants placed into extraction sockets and for implant dehiscences: Surgical techniques and case reports. International Journal of Periodontics & Restorative Dentistry. 1990;10:377-91.
9. Fugazzotto PA, Shanaman R, Manos T, Shectman R. Guided bone regeneration in implant therapy: success and failure rates in 1503 sites. International Journal of Periodontics & Restorative Dentistry. 1997;7:73-6.
10. Werbitt MJ, Goldberg PV. The Immediate Implant Bone Preservation and Bone Regeneration. International Journal of Periodontics and Restorative Dentistry. 1992 Jun 1;12(3):206-17.
11. Lindeboom JA, Tjiook Y, Kroon FH. Immediate placement of implants in periapical infected sites: a prospective randomized study in 50 patients. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2006 Jun 1;101(6):705-10.
12. Schropp L, Isidor F. Timing of implant placement relative to tooth extraction. Journal of Oral Rehabilitation. 2008 Jan;35:33-43.
13. Bhola M, Neely AL, Kolhatkar S. Immediate implant placement: clinical decisions, advantages, and disadvantages. Journal of Prosthodontics: Implant, Esthetic and Reconstructive Dentistry. 2008 Oct;17(7):576-81.
14. Araújo MG, Sukekava F, Wennström JL, Lindhe J. Ridge alterations following implant placement in fresh extraction sockets: an experimental study in the dog. Journal of Clinical Periodontology. 2005 Jun;32(6):645- 52.
15. Araujo MG, Wennström JL, Lindhe J. Modeling of the buccal and lingual bone walls of fresh extraction sites following implant installation. Clinical Oral Implants Research. 2006 Dec;17(6):606-14.
16. Botticelli D, Berglundh T, Lindhe J. Hard-tissue alterations following immediate implant placement in extraction sites. Journal of Clinical Periodontology. 2004 Oct;31(10):820-8.
17. Douglass GL, Merin RL. The immediate dental implant. Journal of the California Dental Association. 2002 May;30(5):362-5.
18. Schropp L, Wenzel A, Kostopoulos L, Karring T. Bone healing and soft tissue contour changes following singletooth extraction: a clinical and radiographic 12-month prospective study. International Journal of Periodontics & Restorative Dentistry. 2003 Aug 1;23(4):313-23.
19. Araújo MG, Lindhe J. Dimensional ridge alterations following tooth extraction. An experimental study in the dog. Journal of Clinical Periodontology. 2005 Feb;32(2):212-8.
20. Caneva M, Salata LA, De Souza SS, Baffone G, Lang NP, Botticelli D. Influence of implant positioning in extraction sockets on osseointegration: histomorphometric analyses in dogs. Clinical Oral Implants Research. 2010 Jan;21(1):43-9.