Immediate loading of implants inserted through impacted teeth in the aesthetic area: A retrospective study with a mean follow-up period of 7 years.

PURPOSE: To evaluate the survival and success rate of and the incidence of complications affecting implants inserted and immediately loaded in sites where an impacted tooth was present in the maxilla. MATERIALS AND METHODS: A total of 10 patients were treated and 14 implants were inserted, 4 in healed sites and 10 in extraction sites. The implant site preparation started in the crestal bone and continued in the enamel and dentine of the impacted tooth. The radiographic depth of implant penetration into the impacted tooth, peri-implant soft tissue and hard tissue condition at the 1-year follow-up and the last follow-up appointment, marginal bone loss at the 1-year follow-up and the last follow-up appointment, and the final aesthetic result were evaluated. RESULTS: The implants healed uneventfully with an adequate hard and soft tissue response and no adverse clinical or radiographic signs or symptoms. They were in function for a minimum of 3 and a maximum of 11 years (mean 7.2 years). CONCLUSION: Although further studies with a larger sample size are required to validate this unconventional approach, it can be considered a valuable clinical option to replace teeth in an area of impaction.

Investigating the effect of insertion torque on marginal bone loss around dental implants.

BACKGROUND/PURPOSE: The use of dental implants in restoring function, esthetics, speech, and health of oral tissues has been growing in recent years. Evaluating marginal bone resorption and the survival rate of implants placed with different torques values is crucial. The primary aim of the present study was to evaluate the effect of different insertion torque values on marginal bone loss around dental implants placed in the posterior region of the mandible. MATERIALS AND METHODS: 37 patients were involved in this study. Patient data (age, gender), implant characteristics (length, diameter), insertion torque values, gingival biotype, and bone quality were recorded, and parallel periapical radiographs measured marginal bone loss. The relationship between variables was obtained using independent t-tests, Pearson correlations, and regressions. RESULTS: The present study found a positive and significant correlation between implant insertion torque and marginal bone loss (MBL)around the dental implants during the first year after placement. Furthermore, patients with D2 bone density at the implant placement site and thin gingival biotype also had significantly higher MBLs from baseline until crown delivery and first-year follow-up than those with D3 bone density and thick gingival biotypes, respectively. CONCLUSION: A lower torque is necessary for high-risk patients to increase implantation success due to identifying patients with an increased risk for MBL.

Immediate implant positioning using tooth-derived bone substitute material for alveolar ridge preservation: Preliminary results at 6 months.

OBJECTIVES: In the present study we evaluated the effectiveness of the use of a novel autologous bone substitute derived directly from processing the extracted tooth in the upper premolar area to preserve a suitable esthetic score and functionality. MATERIAL AND METHODS: Fourteen bone-level implants with platform switching were inserted in 12 patients immediately after atraumatic extraction of premolars for restorative or endodontic reasons. The implant buccal bone gap was filled using autologous tooth extracted-derived material. Clinical and radiographic parameters, including Pink Esthetic Score (PES) were evaluated at 6 months. RESULTS: A total of 10 patients accounting for 11 implants were included. PES showed a suitable esthetic result, and all the implant-prosthetic rehabilitation reported full satisfaction for masticatory function, phonetics, and aesthetics. Bone levels were stable and not affected by implant location, lesion type, or bone quality. CONCLUSION: Radiographically the autologous bone substitute used appears stable in the surgical site and there is good continuity between the autologous bone and the graft. No adverse effects such as periodontal inflammation, infection, or graft rejection was reported.

Aesthetic and radiographic outcomes using the root membrane technique in immediate adjacent implant placement: A retrospective clinical study with a 5- to 9-year follow-up.

PURPOSE: The root membrane technique was designed to preserve the buccal portion of the root in situ, preventing postextraction bundle bone loss and overlying soft tissue recession. Nevertheless, maintenance of the aesthetic gingival architecture around two or multiple adjacent implants, particularly in the anterior maxilla, remains a challenge, notably regarding the gingival contour and the interimplant papillae. The present study aimed to evaluate the clinical, aesthetic and radiographic outcomes for immediate adjacent implants placed using the root membrane technique in the anterior maxilla in a sample with a 5- to 9-year follow-up. MATERIALS AND METHODS: A retrospective clinical study was designed using the medical records of two private dental practices. A total of 40 patients who were treated using the root membrane technique for at least two adjacent implants and single-crown restorations between January 2010 and February 2019 were selected (100 implants). The clinical and radiographic data were analysed to assess implant survival/success, marginal bone loss and the pink aesthetic score. RESULTS: The cumulative survival rate after a mean follow-up period of 81.5 ± 30.5 months was 99.0% (implant-based) and 97.5% (patient-based), respectively. Between 1 and 5 years (n = 99), the mean marginal bone loss changed from 0.39 ± 0.07 mm to 0.36 ± 0.07 mm and subsequently to 0.37 ± 0.07 mm at the 7-year follow-up (n = 71) and 0.33 ± 0.07 mm at the 9-year follow-up (n = 14). The improvement from 1 year was significant at all the follow-up time points (P = 0.000). The mean global pink aesthetic score increased from baseline (11.33 ± 1.03) to 3 months after placement of the final restoration (11.73 ± 0.95) and the final observation (12.01 ± 0.87). This was a significant increase (P = 0.000 baseline to 3 months, 3 months to final observation and baseline to final observation). CONCLUSIONS: In this non-controlled retrospective study, adjacent implants placed using the root membrane technique achieved a satisfactory survival and success rate. The variation in marginal bone loss showed a significant positive trend from 1 year to 5 and 7 years. The overall pink aesthetic scores improved significantly between sequential observation periods. CONFLICT-OF-INTEREST STATEMENT: Dr Leitão-Almeida receives personal fees (for sponsored lectures) and non-financial support from MegaGen (Daegu, South Korea) outside of the submitted work; the other authors declare no conflicts of interests relating to this study.

[Comparison of two-year stability between immediate implant action and delayed implantation for anterior teeth with periodontal disease].

PURPOSE: To investigate the feasibility of immediate implantation after extraction of anterior teeth in patients with periodontal disease and its clinical effect within 2 years. METHODS: Thirty patients (36 implants) who underwent anterior dental implant treatment for periodontal disease from 2016 to 2018 were randomly divided into immediate implantation group (17 implants) and delayed implantation group (19 implants). The patients were followed up for 2 years, the clinical parameters such as periodontal probing depth, pink esthetic score（PES）and implant neck bone resorption volume of implant neck were obtained. The data was statistically analyzed with SPSS 21.0 software package. RESULTS: During the 2-year follow-up period, no implant loss, and there was no significant difference in the depth of peri-implant probing between the two groups at each time point(P＞0.05). There was no significant difference in the volume of bone resorption at implant neck between the two groups(P>0.05). At 6, 12 and 24 months after completion of superstructure repair, there was no significant difference in pink esthetic score（PES）between the two groups (P＞0.05), but there was significant difference in pink esthetic score（PES) at the third month after restoration (P＜0.05). The immediate implantation group obtained more satisfactory soft tissue morphology around the implants. CONCLUSIONS: Under appropriate treatment conditions, there is no significant difference in implant success rate between immediate implantation and delayed implantation of anterior teeth in patients with periodontal disease. At the same time, it reduces the number of operations and shortens the course of treatment. In terms of soft tissue aesthetics, immediate implantation is slightly better than delayed implantation in the early stage after restoration, and can maintain a good soft tissue aesthetic effect.

The effect of loading time on marginal bone change of implants immediately placed after extraction: a retrospective study.

BACKGROUND: The purpose of this study is to compare and analyze the treatment outcomes between two groups which are both immediately placed implant cases, one is immediate loading, and the other is conventional loading group. METHODS: Medical records of the patients who underwent implant treatment which were immediately placed after tooth extraction were analyzed. Demographic data were collected and by using periapical or panoramic radiographic image, marginal bone level and distant crestal bone level were measured. Marginal bone change over time was analyzed and compared between immediate loading group and conventional loading group. RESULTS: A total of 71 patients, 112 immediately placed implants after tooth extraction were initially involved. Measuring was done with implants which had not failed (81). 10 implants were had failed and removed. The others were excluded because of follow-up loss, absence of radiographic image, etc. Demographic data were collected, and measured values were averaged at each follow-up and showed in linear graphs. CONCLUSIONS: In case of immediate implantation of dental implant after extraction, loading time could affect marginal bone level or biological width of the implant. Immediate loading group showed 0.92 mm (mean value) more bone loss compared to conventional loading group at bone-implant contact points 24 months after implantation. At distant crestal points, there was no noticeable difference in bone change pattern between two groups.

Success and patient satisfaction of immediately loaded zirconia implants with fixed restorations one year after loading.

BACKGROUND: There is limited evidence for the use of zirconium dioxide implants in immediate implant placement as well as for related immediate loading protocols. The aim of this retrospective study was to investigate the survival rate, success and patient satisfaction of immediately placed zirconia implants compared to delayed placed implants. METHODS: The study included 58 partially edentulous patients who were treated between 2013 and 2015 with immediate and delayed transgingival healing zirconium dioxide implants (SDS, Kreuzlingen/ Switzerland). In addition to survival and success rate, marginal bone loss was assessed using radiographs and soft tissue was evaluated using Pink Esthetic Score. Oral health-related quality of life was investigated prospectively using a modified OHIP questionnaire. RESULTS: The cumulative survival rate of all implants included was 92% with 88% classified as full success. No significant difference was found between the bone levels of immediately and delayed placed and immediately and delayed loaded implants. The mean Pink Esthetic Score after final prosthetic rehabilitation was 12.2/14 points indicating excellent esthetic clinical results. Analysis of the OHIP questionnaire showed a mean value of 0.54/100 points reflecting a high patient satisfaction. CONCLUSIONS: Immediate and delayed placed as well as loaded zirconium dioxide implants showed excellent results regarding implant success and survival in this study. Zirconium dioxide implants may ensure excellent esthetic results and high patient satisfaction.

Buccal bone thickness at dental implants in the maxillary anterior region with large bony defects at time of immediate implant placement: A 1-year cohort study.

BACKGROUND: There is lack of studies regarding preservation and possible changes in BBT at dental implants. PURPOSE: To assess, on cone beam computer tomograms, the presence of bone at the time of tooth extraction in the maxillary esthetic region and the mean buccal bone thickness 1 month and 1 year after final restoration placement in patients with large bony defects. MATERIAL AND METHODS: In a cohort study, patients were selected presenting a failing tooth with a large bony defect (test group [n = 20]: large bony defect, immediate placed implant and delayed provisionalization). Results were compared with a group in which patients presented a failing tooth without or with a small bony defect: (control group [n = 20]: without or small bony defect, immediate placed implant and delayed provisionalization). Cone beam computer tomograms were made preoperatively, and 1 month and 1 year after placement of the restoration, and buccal bone thickness was analyzed. RESULTS: In both groups approximately 1 mm of buccal bone thickness was present after 1 month and 1 year, without a significant difference between the groups. CONCLUSION: In patients with large bony defects at a failing tooth it was possible to create a bone layer buccally of the implant and this bone layer remained stable during a 1-year follow-up; there were no significant differences between thickness of buccal bone at 1 month and 1 year in patients with large buccal bony defects and patients without or with small bony defects.

Implant survival and patient satisfaction in completely edentulous patients with immediate placement of implants: a retrospective study.

BACKGROUND: This study evaluated full-arch rehabilitation of patients with immediately placed implants in terms of the cumulative implant survival rate, risk factors for implant failure, and patient satisfaction. METHODS: Time-to-event data of 52 completely edentulous jaws (370 implants) were collected using retrospective clinical chart review for the time period from 2008 to 2014. A conventional two stage approach for surgery was adopted to immediately placed implants in the maxilla, and immediate placement and immediate loading protocols for the mandible were followed. The study calculated the 7-year cumulative survival rates (CSR), and a Bayesian hierarchical Cox proportional hazard model was used to measure the effect of covariates. Patient satisfaction on chewing ability, esthetic appearance, and overall satisfaction was also measured with a face-to-face interview survey. RESULTS: Of the total 370 implants, 194 were immediate placement. Two delayed loading maxillary implants failed within the first year, and another one failed in the second year of loading. Two failures were recorded in the first year and one in seven years for the immediate loading mandibular implants. The 1-, 5-, and 7-year CSR of the 370 implants were 0.989 (0.979, 1.000), 0.986 (0.975, 0.998), and 0.978 (0.957, 0.999), respectively. Only the length of the implant affected implant failure (p < 0.05); other patient characteristics, systemic diseases, implant diameter, immediate loading, and immediate placement, did not have an effect on implant failure rates. Patients reported a high degree of satisfaction regardless of their age group or length of the observation period. CONCLUSIONS: Immediately placed implant had CSR as high as delayed placed implants, and 7-year CSRs of immediate loading were not significantly different from delayed loading. The procedure also had a high degree of chewing ability, esthetic appearance, and overall satisfaction. The study results suggested that the clinical procedures applied in this study to completely edentulous patients were acceptable rehabilitation procedures.

Influence of soft tissue grafting, orofacial implant position, and angulation on facial hard and soft tissue thickness at immediately inserted and provisionalized implants in the anterior maxilla.

BACKGROUND: Resorption of hard and soft tissues following immediate implant insertion is frequently reported. Data regarding the influencing factors on facial tissue thickness are rare. PURPOSE: This retrospective study investigated the impact of connective tissue grafting, the orofacial angulation and position of immediately inserted and provisionalized implants on the facial hard and soft tissue thickness in the anterior maxilla within a 1- to 5-year follow-up. MATERIAL AND METHODS: Implants with the prerequisite of having preoperative and postoperative cone beam computed tomography (CBCT) and a follow-up of 1 to 5 years were included. Facial bone deficiencies were grafted flaplessly with autogenous bone in all sites. In a subgroup of implants additional connective tissue grafting was performed, whereas the remaining implants were not grafted with soft tissue. The orofacial tooth and implant angulation, the change of horizontal position and the facial bone thickness were measured by CBCT, the facial mucosa thickness by an ultrasonic device. RESULTS: In total, 76 implants were placed in 55 patients. Sixty-nine sites showed a facial bone defect. Thirty-eight received a connective tissue graft additionally. All implants were still in function after a mean follow-up of 36 months. The mean thickness of the facial mucosa was 1.72 mm at 1 mm, 1.63 mm at 4 mm, 1.52 mm at 6 mm, and 1.66 mm at 9 mm apically to mucosal margin. The bone thickness was 0.02, 0.25, and 0.36 mm initially and 1.32, 1.26, and 1.11 mm finally at 1, 3, and 6 mm apically to implant shoulder level. Mixed model analysis revealed an impact of the preoperative bone status on the facial bone increase. The facial soft tissue thickness was significantly influenced by the gingival biotype. CONCLUSIONS: The results indicate that an initial severe hard tissue defect allows for significant bone regeneration. The facial soft tissue thickness is primarily influenced by the gingival biotype.

Immediate Implant Placement Into Fresh Extraction Sites Using Single-Drilling Bur and Two Loading Procedures: Follow-Up Results.

Modern clinical protocols in implantology aim at shortening the treatment time and reducing duration and discomfort of the surgical phase, while maintaining optimal treatment outcomes. The purpose of this study was to evaluate clinical outcomes of implants immediately placed in extraction sites, using a single drilling step for implant site preparation. One-hundred thirty-three patients (mean age 55.3 ±â€Š12.7 [SD] years, range 20-83 years) were treated at 2 clinical centers. Two-hundred sixty-one implants were inserted in fresh postextraction sockets. One-hundred sixty-five implants were immediately loaded (IL) and 96 underwent delayed loading (DL). Implant survival, peri-implant bone level change and patients' satisfaction were assessed after at least 3 years of function. No patient dropout occurred. The mean follow-up was 63.61 ±â€Š11.52 months (range 39.71-85.71 months) from prosthesis delivery. Two IL and 1 DL implant failed in 3 patients. Implant survival was 98.8% and 99% for IL and DL group, respectively. The mean marginal bone loss after 1 year was 0.48 ±â€Š0.40 mm and 0.52 ±â€Š0.34 mm for IL and DL group. No biological nor mechanical complications occurred. All patients demonstrated full satisfaction. The present protocol with single burs for site preparation produced satisfactory clinical outcomes independent of the loading timing. Further long-term comparative studies are needed to confirm the present findings.

Ten-year follow-up of dental implants used for immediate loading in the edentulous mandible: A prospective clinical study.

PURPOSE: The purpose of this study is to evaluate the 10-year outcome of 25 patients with immediate loading in the edentulous mandible. MATERIAL AND METHODS: Twenty-five patients were consecutively treated with 5 immediately loaded fluoride-modified implants in the edentulous mandible. Implant survival and bone loss were evaluated by an external researcher comparing digital periapical radiographs taken during recall visits with baseline (at implant insertion). Statistical descriptive analysis and nonparametric tests were performed using SPSS v23, multilevel analysis was performed by means of R version 3.1.0. to identify risk factors for bone loss. RESULTS: Twenty-one patients (8 males, 13 females, mean age 68.4, range 49-84) responded to the 10-year recall invitation. No implants were lost during follow-up, resulting in a 100% survival rate. After 10 years, bleeding on probing and plaque were present at 49.5% and 67.6% of the sites, respectively. The mean pocket probing depth was 3.77 mm (SD 0.73, range 3.0-6.83). Bone loss on implant level after 3, 12, 24, and 120 months was 0.16 mm (SD 0.33, range 0-1.75), 0.14 mm (SD 0.24, range 0-1.05), 0.17 mm (SD 0.27, range 0-1.5), and 0.49 mm (SD 1.08, range 0-7.8). Five implants were identified with or at risk for progressive bone loss. Forty-seven percent of the implants did not show any bone loss after 10 years in function and 87% lost less than 1 mm. Multilevel statistical analysis identified 2-year bone loss as a predictor for bone loss after 10 years of function. CONCLUSION: Immediate loading of 5 fluoride-modified dental implants with a fixed prosthetic rehabilitation is a predictable and reliable treatment in the edentulous mandible, based on a 100% implant survival and limited peri-implant bone loss. Implants used for immediate loading in the edentulous mandible who are showing early bone loss may be at higher risk to develop peri-implantitis.

A long-term prospective cohort study on immediately restored single tooth implants inserted in extraction sockets and healed ridges: CBCT analyses, soft tissue alterations, aesthetic ratings, and patient-reported outcomes.

BACKGROUND: Although many studies have been published on single implants, long-term data remain scarce. PURPOSE: To evaluate immediately restored single implants after at least 8 years of follow-up in terms of buccal bone, soft tissue alterations, aesthetic ratings, and patient-reported outcomes. MATERIALS AND METHODS: This prospective cohort study included patients who were consecutively treated with an immediately restored single implant installed in an extraction socket (IIT) or a healed ridge (CIT) in the anterior maxilla. Biomaterials were never used. CBCTs were taken at study termination, soft tissue alterations, and Pink Esthetic Score were evaluated between 1 year and study termination using standardized clinical images. Patient satisfaction was also registered. RESULTS: About 11/16 initially treated patients in the IIT cohort (10 men, 6 women; mean age 45) and 18/23 initially treated patients in the CIT cohort (12 men, 11 women; mean age 40) could be evaluated after more than 8 years. A buccal bone wall less than 2 mm was found at all implant sites. A thin buccal bone wall less than 1 mm was found at 42% of the implant sites. In the CIT cohort, 8 patients had a missing buccal bone in the crestal area, although bone was present at the time of surgery. Alveolar process deficiency significantly deteriorated (P ≤ .046), whereas vertical soft tissue levels and PES remained stable over time in both cohorts. Patients expressed high overall satisfaction. CONCLUSIONS: Substantial dimensional changes may be expected at the buccal aspect of single implants inserted in the premaxilla. As a result, contour augmentation procedures at the time of implant placement should be considered to counteract these bone alterations, even when implants are fully embedded in bone upon insertion.

[Complications of implant-supported full-arch immediate prosthesis: a retrospective analysis of 114 cases].

Objective: To evaluate the feasibility of long-term function of implant-supported full-arch immediate prosthesis via assessing the complications and risk factors. Methods: This historical cohort study included patients treated with implant-supported full-arch restoration under immediate loading protocol between April, 2008 to June, 2016 and wearing the immediate prosthesis for more than 6 months. Medical charts were reviewed for patients' general information, implant information, prosthetic information and details of prosthetic complications. COX proportional hazards ratio model was adopted to analyze the potential risk factors for prosthesis fracture. Results: A total of 114 patients with a mean age of (56.7±10.2) years old and 144 prostheses were included. The median wearing time of immediate prosthesis was 17.6 months. Sixty-two (54%) patients experienced prosthetic complication, 30 of them suffered more than once. Artificial teeth fractures were more common in anterior region while resin base fractured more often in the posterior region. The possibility of immediate prosthesis fracture in the first year was high but declined over the following years. COX regression analysis showed that fibre-reinforcement (HR=0.486, P=0.017) and rigid opposing dentition (HR=2.272, P=0.016) were significantly related to the prosthesis fracture. Conclusions: Long-term function of implant-supported full-arch immediate prosthesis renders a high prosthetic complication prevalence, featuring the prosthesis fracture as the most common complication and the first year of highest fracture probability. Fibre-reinforced acrylic immediate prosthesis may function well in cases with a removable denture restored opposing jaw.

Immediately loaded implant-supported full-arches: Peri-implant status after 1-9years in a private practice.

OBJECTIVE: Evaluate the peri-implant status on the long-term (1-9years) of patients treated with immediately-loaded full-arch prostheses in a private practice. METHODS: A retrospective cohort study was carried out in patients consecutively treated with immediately loaded full-arch restorations supported with a minimum of 4 implants (Replace® Tapered, Nobel Biocare AB) and Multi-Unit conical abutments (MUA®, Nobel Biocare AB) with a follow-up of over 12months after placement of the final prosthesis. RESULTS: A total of 378 implants were placed in 56 patients. Forty upper and 32 lower arches were restored, and 16 patients received bimaxillary rehabilitation. The mean duration of follow-up was 50 months, and the implant and patient peri-implantitis prevalences were 14.3% and 50%, respectively. Mucositis affected 56.9% of the implants and 50% of the patients. The survival rate was 96.4% by patient, but reached 99.5% in the implant-based analysis, and the success rate was 95.5% for implants and 80.4% for patients. CONCLUSIONS: Immediately-loaded full-arch restorations have an acceptable outcome after 1-9years of follow-up. However, the incidence of peri-implant diseases is high, and further research is needed to confirm whether these may compromise the predictability of the prostheses over the long-term. CLINICAL SIGNIFICANCE: After a mean follow-up of 50months, the incidence of mucositis and peri-implantitis affected the 96.4% and 50% of patients, respectively. However, these results were reduced almost by half when the threshold of bleeding on probing and peri-implant bone loss applied was less strict.

Prognosis of Dental Implants Immediately Placed in Sockets Affected by Peri-implantitis: A Retrospective Pilot Study.

The aim of this study was to describe a protocol and analyze the outcomes of immediate replacement of failed implants due to peri-implantitis. A total of 17 patients (mean age: 58 ± 10 years) had 22 failed implants that were immediately replaced. One implant failed 16 months after insertion, resulting in an implant survival rate of 94.7%. The mean follow-up time was 40 ± 16 months (range: 9-52 months) after insertion. Mesial and distal bone loss were 0.89 ± 0.62 mm and 0.97 ± 0.66 mm, respectively. Immediate implant replacement could be considered in the management of implant failure due to peri-implantitis.

Immediately Loaded, Implant-Supported Overdentures Retained by a Milled Bar: An Up-to-5-Year Retrospective Clinical Study.

This study was conducted as an up-to-5-year retrospective investigation estimating survival rate, marginal bone loss (MBL), patient satisfaction, complications, and required prosthodontic maintenance for immediately loaded, milled bar-retained, implant-supported overdentures (ISOs). A total of 60 patients, 69 overdentures, and 179 implants were examined. The implant survival rate was 96.65%, and the mean MBL was 0.57 mm (SD 0.52). High subjective satisfaction ratings, ranging from 3 to 5 with a mean of 4.3 (SD 0.6), were observed. The incidence of complications and prosthetic maintenance was low and required short standard appointments. The present findings encourage the use of immediately loaded, milled bar-retained ISOs.

Cutting-Edge Implant Rehabilitation Design and Management: A Tapered Abutment Approach.

Immediate implant placement can pose challenges surgically and, ultimately, restoratively. Yet immediate placement has become the standard when adequate bone is present to achieve primary stability and site infection is minimal. To avoid prosthetic complications and ensure the implant is encased in bone after healing, proper planning must consider that implant placement does not necessarily need to follow the trajectory of the root socket. As discussed in this article, maxillary anterior sites have potential issues related to the "triangle of bone" that are not encountered in molar sites and demand different approaches to ensure treatment success. Additionally, this article addresses decision-making on molar sites in regard to implant diameter, as well as the rationale for platform switching.

Implante imediato associado ao enxerto de tecido conjuntivo: relato de caso clínico / Immediate implants with connective tissue association: a case report

Os implantes imediatos são uma realidade e também uma evolução das técnicas primeiramente preconizadas para reabilitação implantar, as quais visavam apenas, reabilitação de mandíbulas em axilas edêntulas, em que as exodontias tinham sido realizadas há algum tempo, e o osso alveolarjá se encontrava remodelado. A implantação imediata é uma técnica onde o implante é instalado no alvéolo fresco, imediatamente após a exodontia. A vantagem dessa modalidade de tratamento é a redução do tempo clínico, além da preservação da forma dos tecidos moles circundantes ao implante, preservando a arquitetura peri-implantar, otimizando a estética. Porém, antes de realizarmos este tipo de procedimento devemos avaliar a real indicação da colocação do implante concomitante a exodontia, através de exames clínico e radiográfico, pois um fator de extrema importância para o sucesso desta técnica, é que o implante instalado consiga uma boa estabilidade primária no momento da instalação. Os implantes imediatos podem ser incorporados como uma técnica a ser realizada em diversos casos clínicos, devendo sempre ser observadas as limitações dos casos a fim de serem alcançados excelentes resultados. Este trabalho tem por objetivo o relato de um caso clínico onde é realizada a instalação de implantes imediatamente após a exodontia.

Immediate implants are a reality and also an evolution of the first recommended techniques to implant rehabilitation, which were aimed only rehabilitation of the edentulous upper and lower jaws where the extractions were carried out for some time, and the alveolar bone was already renovated. The immediate implantation is a technique where the implant is installed in the fresh socket immediately after extraction. The advantage of this mode of treatment is to reduce the clinical time, inaddition to preservation of the shape from the surrounding soft tissue around the implant preserving the peri-implant architecture, optimizing the aesthetics. But before we perform this type of procedure we must assess the real indication of the placement of concomitant implant tooth extraction,through clinical and radiographic examinations cause a factor of great importance for the success ofthis technique is that the installed implant achieve a good stability primary at installation time. Immediate implants can be incorporated as a technique to be used in several clinical cases and should always be subject to the limitations of the cases to be achieved excellent results. This work aims to report a clinical case where implant installation is performed immediately after extraction.

Dental Implants With Immediate Loading Using Insertion Torque of 30 Ncm: A Systematic Review.

OBJECTIVE: This study aimed to perform a review of the literature regarding the survival rate of dental implants with immediate loading using insertion torque of 30 Ncm. MATERIAL AND METHODS: A systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Cochrane Handbook for Systematic Reviews of Interventions (PROSPERO CRD42014015323). The search was performed in the PubMed, Web of Science, Cochrane Library electronic, OVID, and Scielo databases. Manual searches were also performed. The articles identified were assessed independently by 3 researchers. Clinical trials reporting dental implants with immediate loading and 30 Ncm torque in patients ages 18 years or older were included. RESULTS: The searches yielded 589 studies. Six studies were included in the systematic review. The survival rate of dental implants was 96.8%. Three studies showed a low potential risk of bias. CONCLUSION: There is not strong evidence that insertion torque of 30 Ncm is enough for implant survival in cases of immediate loading.