Jul 2026· International Journal of Oral Health Dentistry· Vol 12, pp. 108-112· 0 citations· 7 references
TL;DR
Immediate placement of implants in the posterior region of the mandible is achievable when sufficient bone height and primary stability are attained and the processes of socket grafting and atraumatic extraction are essential for achieving successful results in cases involving hopeless teeth.
Abstract
Background: The immediate placement of implants after the extraction of non-salvageable teeth results in shorter treatment durations and enhanced patient satisfaction. However, placing implants in the posterior region of the mandible poses difficulties due to the quality of the bone and its closeness to the mandibular canal. Case Presentation: A 45-year-old male patient arrived with a vertically fractured mandibular second molar (tooth #36) deemed hopeless due to vertical bone loss, root fracture, and being endodontically non-restorable. After performing an atraumatic extraction and socket debridement, a titanium implant measuring 6 (cid:2) 10 mm was inserted with an insertion torque of 45 Ncm. Outcomes: At 6-month follow-up, radiographic evaluation revealed stable marginal bone levels (0.4 mm loss), healthy peri-implant soft tissue, and satisfied occlusion. No complications occurred. Conclusion: Immediate placement of implants in the posterior region of the mandible is achievable when sufficient bone height (greater than 10 mm) and primary stability (exceeding 35 Ncm) are attained. The processes of socket grafting and atraumatic extraction are essential for achieving successful results in cases involving hopeless teeth.
Background and Clinical Significance: Immediate implant placement in mandibular molars represents a clinical challenge due to lower trabecular bone density and anatomical limitations of the interradicular septum. Osseodensification has been proposed as an alternative to improve primary stability in sites with low bone quality. Case Presentation: This report describes the case of a 54-year-old female patient with a mesial root fracture in the lower right first molar, treated by atraumatic extraction followed by immediate implant placement using a densifying drilling protocol. After careful root removal, the interradicular septum was expanded using Versah burs at 1200 rpm, allowing placement of a 4.0 × 7 mm Implacil Duecone implant with a final insertion torque of 25 Ncm. The residual gap was filled with a xenogeneic bone substitute and covered with a dense polytetrafluorethylene membrane for alveolar preservation. Healing progressed uneventfully and, after four months, adequate bone formation was observed, enabling prosthetic rehabilitation with a single ceramic crown. After 4 postoperative years we could find peri-implant tissue stability. Conclusions: The clinical outcome supports current evidence indicating that osseodensification may enhance initial stability and predictability of immediate implants placed in posterior mandibular regions.
Márcio de Carvalho Formiga, Jucielly Santos Lesnik de Souza, Gustavo Dos Santos Coura et al.· Reports· 0 citations
Background: Autologous dentin has emerged as a potential grafting material in regenerative oral surgery because of its structural and biological similarities to bone. This technical report describes a modified tooth-shell technique used for horizontal ridge reconstruction with simultaneous implant placement in two clinical cases involving the aesthetic zone. Case Presentation: The first case involved a 29-year-old female patient requiring extraction of a partially impacted, buccally positioned maxillary third molar (tooth 28). The extracted tooth was processed intraoperatively to obtain a dentin shell, which was fixed as a buccal plate during simultaneous implant placement. The remaining defect was filled with sticky bone prepared from biphasic calcium phosphate combined with platelet-rich fibrin. Radiographic evaluations performed at 4 and 6 months demonstrated stable ridge contours, while clinical follow-up continued for 2 years with maintenance of implant function and peri-implant tissue stability. The second case involved a 58-year-old female patient with a previous failure of immediate implantation in the anterior maxilla associated with implant overload, loss of implant stability, and buccal bone deficiency. After soft- and hard-tissue healing, ridge reconstruction was performed using a dentin shell prepared from tooth 18 together with simultaneous implant placement and immediate provisional restoration. Follow-up after 6 months revealed stable peri-implant tissues, a satisfactory aesthetic outcome, and successful prosthetic rehabilitation. Conclusions: The modified tooth-shell technique using autologous dentin provided satisfactory preliminary clinical and radiographic outcomes in both cases. These findings should be considered hypothesis-generating and require confirmation in larger prospective studies with longer follow-up periods.
Jan Łoś, Justyna Szałkowska-Łoś, Michał Pikuła et al.· Journal of Functional Biomat...· 0 citations
Tooth loss has been a longstanding issue, prompting the exploration of various treatment modalities. Dental Implants have emerged as one such biocompatible treatment modality for replacement of missing teeth. Following tooth extraction preservation of facial alveolar bone and soft-tissue architecture is critical for achieving optimal aesthetic outcomes in the anterior maxilla. Physiologic post-extraction remodelling, particularly resorption of the buccal plate, often compromises aesthetic results even with immediate implant placement. Conventional extraction and implant protocols may not completely prevent these dimensional changes. The Socket-shield Technique (SST) is a biologically driven approach that aims to preserve the periodontal ligament-bundle bone complex through intentional retention of the buccal root fragment, thereby limiting post-extraction hard and soft-tissue collapse. Hereby, the authors described the clinical application of SST with immediate implant placement in a 27-year-old male patient presenting with repeated fracture of a composite restoration in a previously endodontically treated maxillary left central incisor (21). Clinical and radiographic follow-up demonstrated preservation of the facial bone contour, stable peri-implant soft-tissues and favourable aesthetic outcomes. Within the limitations of a single case, SST appears to be a viable option for managing aesthetically demanding anterior maxillary implant sites when performed with careful case selection and surgical precision.
A. Firdose, D. Preetha, K. Nagasurthi et al.· Journal of Clinical and Diag...· 0 citations
Immediate implant placement (IIP) and loading protocols have emerged as predictable treatment strategies in contemporary dentistry, particularly in the esthetic zone. These approaches offer advantages such as reduced treatment time, preservation of peri-implant soft tissue architecture, and improved patient satisfaction. However, biological and prosthetic prerequisites, including adequate bone and soft tissue support and primary stability, must be fulfilled to ensure long-term success. This case report presents the management of an 18-year-old female patient with high esthetic demands who underwent IIP, grafting, and provisionalization in the maxillary anterior region. Following atraumatic extraction and implant placement with sufficient stability, grafting was performed and a screw-retained provisional restoration was delivered within 24 h. After a 3-month healing period, definitive zirconia implant-supported restorations were fabricated and cemented. Over a 10-month follow-up, no complications were observed, and satisfactory esthetic and functional outcomes were achieved. The results indicate that, with proper case selection, sufficient primary stability, and careful prosthetic planning, immediate implant loading can provide reliable and predictable outcomes.
M. N. Ürün, M. Toprak, Serdar Polat· Akdeniz Diş Hekimliği Dergis...· 0 citations
Longitudinal fractures in endodontically treated teeth, especially after trauma, often present an unfavorable prognosis, associated with pain, fistula, and bone resorption. Immediate implant placement associated with regenerative techniques and immediate loading can offer a predictable solution for esthetic and functional restoration. Case report: A 35-year-old female patient presented with longitudinal fracture of tooth #12 with periapical lesion and fistula. Careful extraction, curettage, and socket decontamination with active oxygen gel (blue®m) were performed. A Helix Acqua GM Neodent implant (3.5 × 16 mm) with 60 N·cm insertion torque was placed, positioned 3 mm subcrestal. A universal abutment torqued at 20 N·cm was adapted, followed by placement of a provisional tooth previously milled in PMMA. The bone defect was filled with bone graft (Straumann® cerabone®)) and covered with a resorbable membrane (Straumann® Jason® membrane), associated with a de-epithelialized connective tissue graft from the palate. Clinical and radiographic follow-up demonstrated fistula resolution, provisional stability, preservation of peri-implant tissues, and favorable esthetic contour. Conclusion: Single-stage treatment combining immediate implant placement, immediate loading, bone grafting, connective tissue grafting, and active oxygen gel proved to be an effective alternative for root fracture cases in the esthetic zone, providing predictable rehabilitation with satisfactory clinical and esthetic results.
R. Pes, Evandro Antonio Garcia, Hassan Yussef Saleh et al.· Journal of Orofacial Innovat...· 0 citations
In the era of esthetic dentistry, several protocols have been introduced that bring down the ill effects of tooth loss. Replacement of teeth with thin buccal bone is challenging in maxillary anterior region. In the last decade partial root retention technique also known as socket shield technique (SST) has gained attention in preserving buccal bone while placement of implants. Hereby presenting 2 cases that describe partial root retention technique in grossly destructed anterior teeth with immediate implant placement. Prosthesis loading was completed after 4-5 months. Patients were followed up to 1 year and at the end of 1year peri-implant phenotype was recorded and compared with baseline values. SST requires precision and when cautiously implemented results in promising outcomes. Periodontal phenotype was preserved adequate till 1 year follow-up in both the cases.Keywords: Socket shield technique (SST), immediate implant, peri-implant phenotype.
Anuradha Bhatsange, Sanıka Kamble, Shruti Kulkarnı et al.· Current Research in Dental S...· 0 citations
