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    Immediate Dental Implants

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    Immediate Dental Implants

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    Immediate Dental Implants

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    See discussions, stats, and author profiles for this publication at: https://www.researchgate.

    net/publication/367008605

    Immediate Dental Implants

    Presentation · January 2023


    DOI: 10.13140/RG.2.2.32884.63363

    CITATIONS READS

    0 303

    1 author:

    Shimaa Hussein Kotb


    Sphinx University in Egypt
    59 PUBLICATIONS 5 CITATIONS

    SEE PROFILE

    All content following this page was uploaded by Shimaa Hussein Kotb on 10 January 2023.

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    Immediate Dental Implant
    Immediate Dental implant

    • Dr. Shaymaa Hussein Rafat Kotb


    • Master degree in oral Medicine ,periodontology ,Alazhar university.

    • M RCSI, RCSEng ,RCSEd , RCPSG


    • Introduction
    • Types od Dental implants
    • Aim of therapy
    • Selection of patients
    • Inclusion crieteria
    • Exclusion crieteria
    • Guidlines for every step in implant placement
    • Advantages
    • Disadvantages
    • Case Report
    • Results
    • Recommendation
    • References

    Outlines
    • Implant dentistry has become increasingly important in oral
    reconstruction since the intra-oral use of titanium implants in
    late 1950 .
    • The philosophy behind successful implant restoration became
    known as restoration driven implant placement
    • Many factors should be considered to obtain a successful
    implant such as patient selection ,surgical technique ,ideal
    placement and osseointegration .
    • Treatment planning decision can be conducted through
    interpretation cone beam computarized tomography CT.

    Introduction
    • Dental Implant Defined as “ a prosthetic device
    implanted into the oral tissues beneath or within the bone
    to provide retention and support for final prosthesis .
    • Dental Implant : has emerged as a novel rehabilitation
    option for missing teeth in last two decades
    • Dental implants remain the most reliable ,functional
    ,aesthetics alternative compared to traditional used
    prosthetics appliances

    Dental Implant
    Modern implant dentistry aims at improving
    patient masticatory function, aesthetics,and overall
    quality of life. Dental implants achieve these aims
    via the concept of osseointegration.
    In 1969, Per-Ingvar Branemark described
    osseointegration as ―a direct structural and
    functional connection between ordered living bone
    and the surface of the load-covering implant‖

    Dental Implant
    Immediate Delayed
    implants implants

    In fresh
    In healed
    extracted
    socket
    socket

    After 8
    At time of
    weeks or
    extraction
    more

    Types of Denatl implants


    Immediate Delayed
    implants implants
    Can,t restore
    Natural look natural look until
    since first day crown inserted 6
    months later

    Need
    No bone surgery bone,gingival
    needed displacement
    surgery

    Types of Dental implants


    The success of dental implant directly related to
    patient evaluation :
     Medical History
    Dental History
    Radiographic Evaluation
    precious Diagnosis and treatment planning result in
    excellent outcomes .

    Dental implant
    • To thorough the light on the Advantages,
    disadvantages of immediate dental
    implant in restoring the normal function,
    aesthetics, speech at the same time of
    extraction the tooth

    Aim OF study
    Clinical Diagnosis

    Radiographic Interpretation

    Treatment plan

    Patient and Method


    • Diagnosis : correct diagnosis result in proper treatment plan and
    consequent long term prognosis
    • Medical History : ( Absolute containdicated )avoid
    immunosuppression ,bleeding problems ,drug abuse ,bisphosphonate
    drugs
    • Relative contraindications: adolescent ,osteoprosis ,smoking
    ,uncontrolled diabetes .
    • Dental History : Gingival phenotype ,Periodontal examiniation
    include soft &hard tissues supporting structure.)
    • Occlusal analysis is mandatory to avoid failure
    • Radiographic examination : CBCT& 3D imaging show
    reformatting images of bone quality and quantity at each desires
    surgical plan ,bone width & bone hight .

    Patient and Method:


    Selection of Patients
    Selection criteria
    • Inclusion criteria:
    • the tooth being extracted due to endodontic
    involvement, root fracture, root resorption, periapical
    pathology , root perforation, or unfavorable crown-to-
    root ratio.
    • Atraumatic extraction procedure
    Exclusion criteria
    • Smokers
    • Pregnant ,lactated female patients
    • Patients with parafunctional habits such as bruxism
    • Perforation of alveolar bone following tooth removal
    • Patient with comporomised diseases condition
    • Inability to achieve primary implant stability following
    implant placement
    • Necessary to extract with no or little disturbances to
    surrounding bone as possible.
    • Using periotome for traumatic extraction is the key for
    immediate implant success
    • Immediate implant refer to placement of implants into
    fresh extraction sockets immediately after extraction
    • Selecting the proper implant size allow to remain stable
    in position
    • Flapless surgery

    Guidelines for every step


    in implant placement
    Patient acceptability
    Placed at the same time after tooth extraction
    Flapless technique so no need for bone carving or gum
    displacement
    Without stitches
    Reduce patient discomfort & pain
    Natural profile for your tooth & soft tissues from the first
    day
    Few clinic visit
    Cost effectiveness

    Advantages of immediate
    implant vs standard implants
    Infection at implant site
    Thin gingival phenotype
    Sever periodontal diseases
    No enough bone (fenestration ,Dehescence)
    Proximity to vital structure(max sinus)

    Limitation make immediate


    implants not applicable at
    time
    Technically need Expert operator
    Lack of control on final implant position
    Increase possibility of infection
    Difficult primary stability
    Inadequate soft tissue coverage
    Difficulty in preparing the osteotomy due to bur
    movement along the extraction site walls
    The additional cost of bone grafting.

    Disadvantages of
    Immediate implants
     32-year-old female, who was clinically fit (no systemic disease),
    and did not present bruxism ,presented to the Department of Oral
    and Maxillofacial Surgery at Alazhar university 2020.
     The patient’s main complaint involved fractured maxillary second
    premolar with total loss of two third of crown structures—#15—that
    had suffered recent prosthetic losses, thus rendering the patient
    functionally and aesthetically impaired.
     Medical data and complementary examinations confirmed normal
    health conditions.
     Cone Beam Computed Tomography(CBCT) confirmed the clinical
    findings of tooth no#15 having extensive caries .
     The patient gave his informed consent to publish the details of the
    case and any accompanying images.

    Case report
    Radiographic Examination
    Clinical photograph
    showing badly
    destructed tooth
    Clinical photograph
    showing Minimal invasive
    Surgical extraction
    Clinical photo showing
    Implant placement
    procedure
    Healing abutment
    Final restoration
    postoperative X-ray
    after placement final
    restoration (6 months
    later).
    The results were highly satisfactory and approved by
    the patient. The patient was followed-up monthly for the
    next 12 months, wherein we assessed :
    the implants’ stability,
     possible bone loss,
    gingival health,
    and aesthetic conditions were also assessed .

    Results
    No signs or symptoms of pain, tenderness, redness or
    inflammation of soft tissue around the inserted
    implant site throughout the study

    No signs of infection, gingivitis or peri-implantitis at


    follow up periods.

    Excellent result of osseointegration between bone and


    implant surface
    Overall Survival rates : 95%

    Results
     Correct planning ,
     Precise manipulation of soft tissues
    The use of new technologies associated with
    planning of surgical technique.
     By following these guidelines: grant the patient
    acceptance and Positive excellent results in
    regards to clinical, radiographic and aesthetics
    outcomes of implant survival and minimal changes in
    soft & hard tissues around immediate implants

    Results
    Placement of dental implants into fresh
    extraction sockets has major advantages
    over delayed placement,(such as):
     Reduced overall treatment time
    Reduce the number of surgical procedures ,
    Reduce patient discomfort
    Increase patient acceptance

    Conclusions
    without adequate oral health control as presented in
    this clinical case, the chances of developing peri-implant
    mucositis are very high, and may lead to aesthetic and
    functional failure.

    Conclusion
    Advice patient of meticulous oral hygiene
    Advice about using antiseptic mouthwash
    Advice patient about followup at regular interval
    Advice patient ,if he feel any abnormal symptoms should
    consult with his dentist quickly .
    Advice patient to eat healthy diet (riched with vegetables
    and fruits)

    Recommendation
     Block, M.S. Dental Implants: The Last 100 Years. J. Oral Maxillofac. Surg. 2018, 76, 11–
    26.
     Cosyn, J.; De Lat, L.; Seyssens, L.; Doornewaard, R.; Deschepper, E.; Vervaeke, S. The
    effectiveness of immediate implant placement for single tooth replacement compared to
    delayed implant placement: A systematic review and meta-analysis. J. Clin. Periodontol.
    2019, 46, 224–241.
     Báez-Marrero, N.; Rafel, J.L.; Rodríguez-Cárdenas, Y.A.; Aliaga-Del Castillo, A.; Dias-
    Da Silveira, H.L.; Arriola-Guillén, L.E.Accuracy of computer-assisted surgery in
    immediate implant placement: An experimental study.J. Indian Soc. Periodontol.2022 ,26,
    219–223
     Tonetti, M.S., Cortellini, P., Graziani, F et al. Immediate versus delayed implant
    placement afteranterior single tooth extraction: the timing randomised controlled clinical
    trial. Journal of ClinicalPeriodontology 2017; 44, 215–224.
     Lang, N.P., Pun, L., Lau, K.Y., Li, K.Y. & Wong, M.C. A systematic review on survival
    and successrates of implants placed immediately into fresh extraction sockets after at least 1
    year. Clinical Oral Implants Research 2012; 23(5), 39–66
     Botticelli D, Renzi A, Lindhe J, Berglundh T. Implants in fresh extraction sockets: a
    prospective 5-year follow-up clinical study. Clin Oral Implants 2008;19(12):1226-32.

    References
    Dr. Shaymaa Hussein Rafat Kotb
     Master degree in oral Medicine ,periodontology ,Alazhar university
     M RCSI , RCSEng , RCSEd , RCPSG

    Thank you
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