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Immediate implant placement in molar extraction sites: a 1-year prospective case series pilot study.

ABSTRACT: BACKGROUND:There is a growing tendency to place single tooth implants immediately after extracting a failing tooth in the posterior region. The aim of this prospective case series pilot study was to evaluate immediate implant placement in molar post-extraction sites during a 1-year follow-up period. MATERIALS AND METHODS:Fifteen consecutive patients with a single failing molar in the maxilla or mandible, and presenting enough bone to expect primary implant stability and an implant site free of infection, were included. The implants, with a large thread depth and sharp thread edges, were placed in each patient according to a two-staged surgical procedure. Three months later, a full contour screw-retained zirconia restoration with an angulated screw channel abutment was provided. Clinical and radiographic examinations were performed 1 month and 12?months after placing the restoration. In addition, the patients' satisfaction with the restoration was scored after 12?months. RESULTS:Four out of 15 of the mobile implants had to be removed before the 1-year evaluation. The implant and restoration survival rates were 73.3% at the 1-year evaluation (n?=?15). The mean marginal bone loss, from loading to the 12-month follow-up, was 0.17?mm (n?=?11). The mean plaque, calculus, peri-implant mucosa, bleeding, and pocket probing depth scores were low, depicting healthy peri-implant conditions. The patients were very satisfied. CONCLUSION:It was demonstrated, within the limitations of this study, that immediate placement of regular diameter implants in molar post-extraction sites in the maxilla and mandible resulted in a high implant failure rate during a 1-year follow-up period. TRIAL REGISTRATION:Netherlands Trial Register, NL8117. Registered 24 October 2019 - Retrospectively registered, https://www.trialregister.nl/trial/8117.

SUBMITTER: Meijer HJA

PROVIDER: S-EPMC7013013 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Immediate implant placement in molar extraction sites: a 1-year prospective case series pilot study.

Meijer Henny J A HJA Raghoebar Gerry M GM

International journal of implant dentistry 20200212 1

<h4>Background</h4>There is a growing tendency to place single tooth implants immediately after extracting a failing tooth in the posterior region. The aim of this prospective case series pilot study was to evaluate immediate implant placement in molar post-extraction sites during a 1-year follow-up period.<h4>Materials and methods</h4>Fifteen consecutive patients with a single failing molar in the maxilla or mandible, and presenting enough bone to expect primary implant stability and an implant ...[more]

PMID: 32048081

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Project description:BACKGROUND:Immediate implants are frequently employed in the anterior maxillary area. However, the installation of dental implants simultaneously with tooth extraction can also provide with benefits in the posterior areas with a reduction in time prior the recovery of the masticatory function. Results previously reported in the literature show high-survival and success rates for implants placed in extraction sockets in molar areas; however, this topic has received limited systematic analysis. MATERIAL AND METHODS:Electronic and manual literature searches were performed by two independent reviewers in several data-bases, including MEDLINE, EMBASE, and Cochrane Oral Health Group Trials Register, for articles up to January 2019 reporting outcomes of immediate implants placed in molar areas. Primary outcomes included survival and success rates, as well as marginal bone loss. Secondary outcomes included the influence of implant position, type of implant connection, grafting protocol, flap or flapless approach, implant diameter, surgical phase, presence of buccal plate, and loading protocol. RESULTS:Twenty studies provided information on the survival rate, with a total sample of 1.106 implants. The weighted mean survival rate of immediate implants after 1 year of follow-up was 96.6%, and the success rate was 93.3%. On the other hand, marginal bone loss was 1.29 ± 0.24 mm. Secondary outcomes demonstrated that grafting the gap and the loading protocol have an effect on survival and success rates. Similarly, the presence or absence of the buccal bone affect crestal bone levels. Meta-analysis of 4 investigations showed a weighted mean difference of 0.31 mm ± 0.8 IC 95% (0.15-0.46) more marginal bone loss at immediate implant placement versus implants in healed sites (p < 0.001) I2 = 15.2%. CONCLUSION:In selected scenarios, immediate implant placement in molar extraction socket might be considered a predictable technique as demonstrated by a high survival and success rates, with minimal marginal bone loss.

Project description:PurposeThis randomized controlled clinical trial compared soft tissue changes following a novel vestibular atraumatic extraction technique (test group) versus the conventional incisal atraumatic extraction approach (control group) while implementing the vestibular socket therapy for immediate implant placement.MethodsThirty patients with hopeless maxillary anterior teeth requiring atraumatic extraction were randomly assigned into two equal groups to receive either test or control. Vertical soft tissue alterations in mm were measured at baseline and 12 months post-restoration using intraoral digital scans at three reference points, distal papilla, mid-facial gingival margin, and mesial papilla, as well as pink esthetic scores (PESs) after 12 months.ResultsVestibular extraction technique showed significant soft tissue improvement and creeping when compared to incisal extraction (P < 0.05). The test group showed soft tissue measurements with a mean (± SD) of 0.26 (± 0.58), 0.39 (± 0.64), and 0.05 (± 0.37) mm for the mesial papilla, mid-facial gingival margin, and distal papilla respectively. While the incisal extraction technique demonstrated gingival recession at the distal papilla, mid-facial gingival margin, and mesial papilla of - 0.37 (± 0.54) mm, - 0.32 (± 0.68) mm, and - 0.39 (± 0.59) mm respectively. The overall PESs after 12 months were 12.67 (± 1.59) in vestibular extraction group, while incisal extraction group was 11.40 (± 1.40), with significant difference between them (P = 0.03).ConclusionThis investigation suggests that both studied techniques were successful in the atraumatic extraction of hopeless severely damaged teeth. The novel vestibular extraction technique might be considered an alternative reliable atraumatic extraction approach compared to the conventional incisal extraction when performing the vestibular socket protocol for immediate implant placement with soft tissue enhancement.

Project description:ObjectivesTo evaluate clinical, radiological performance of novel digital workflow integrating dynamic navigation to streamline in one-visit single-implant immediate loading in aesthetic zone.Material and methodsConsecutive patients requiring one single-implant in aesthetic zone of both jaws were treated between May and September 2017. Primary outcomes were implant and prosthetic success rates, surgical and prosthetic complications, marginal bone loss (MBL), final pink aesthetic score (PES-f), and implant stability quotient (ISQ-f). Secondary outcomes were ISQ-0 and PES-0 at implant positioning and PES-p at definitive prosthesis placement. Potential effect of jaw (maxilla vs mandible), biotype (thin vs thick), type of incision (flap vs flapless), and implant site (healed vs. post-extractive) on the primary outcomes (MBL, PES-f, and ISQ-f) was evaluated through a multivariable analysis.ResultsFifty-two implants were placed (follow-up 18.6, 15-20 months). One post-extractive implant failed. No other surgical, biological complications occurred, accounting for 98.10% cumulative success rate (CSR). No definitive prostheses failed. Mean MBL was -0.63 ± 0.25 mm (-1.69 to -0.06). PES-f was 12.34 ± 1.41 (9-14). ISQ-f was 78.1 ± 3.2 (70-84). Age had significantly negative effect on MBL and PES-f (p = .0058 and p = .0052). No other variables significantly affected primary outcomes.ConclusionsWithin study limitations, investigated digital workflow integrating dynamic navigation was reliable for single-implant immediate loading in aesthetic zone in one visit. No statistically significant difference was found for MBL, PES-f, and ISQ-f, considering type of incision (flap vs. flapless), implant site (healed vs post-extractive), jaw (maxilla vs. mandible), and biotype (thick vs. thin). Live-tracked dynamic navigation may have contributed to improve operator clinical performance regardless of implant site characteristics. Further investigations are needed to confirm positive outcomes.

Project description:BackgroundImplant-based breast reconstruction (IBBR) is the most commonly performed reconstructive procedure following mastectomy. IBBR techniques are evolving rapidly, with mesh-assisted subpectoral reconstruction becoming the standard of care and more recently, prepectoral techniques being introduced. These muscle-sparing techniques may reduce postoperative pain, avoid implant animation and improve cosmetic outcomes and have been widely adopted into practice. Although small observational studies have failed to demonstrate any differences in the clinical or patient-reported outcomes of prepectoral or subpectoral reconstruction, high-quality comparative evidence of clinical or cost-effectiveness is lacking. A well-designed, adequately powered randomised controlled trial (RCT) is needed to compare the techniques, but breast reconstruction RCTs are challenging. We, therefore, aim to undertake an external pilot RCT (Best-BRA) with an embedded QuinteT Recruitment Intervention (QRI) to determine the feasibility of undertaking a trial comparing prepectoral and subpectoral techniques.Methods and analysisBest-BRA is a pragmatic, two-arm, external pilot RCT with an embedded QRI and economic scoping for resource use. Women who require a mastectomy for either breast cancer or risk reduction, elect to have an IBBR and are considered suitable for both prepectoral and subpectoral reconstruction will be recruited and randomised 1:1 between the techniques.The QRI will be implemented in two phases: phase 1, in which sources of recruitment difficulties are rapidly investigated to inform the delivery in phase 2 of tailored interventions to optimise recruitment of patients.Primary outcomes will be (1) recruitment of patients, (2) adherence to trial allocation and (3) outcome completion rates. Outcomes will be reviewed at 12 months to determine the feasibility of a definitive trial.Ethics and disseminationThe study has been approved by the National Health Service (NHS) Wales REC 6 (20/WA/0338). Findings will be presented at conferences and in peer-reviewed journals.Trial registration numberISRCTN10081873.

Dataset Information

Immediate implant placement in molar extraction sites: a 1-year prospective case series pilot study.

Publications

Immediate implant placement in molar extraction sites: a 1-year prospective case series pilot study.

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