Immediate Implant Placemenet in Infected Sites: A case Series.

Abstract BACKGROUND: Immediate implant placement has several advantages, such a reduction in the number of surgical treatments and reduction of the time between tooth extraction and the placement of the definitive prosthesis. However, there are still some situations which could jeopardize the success of the aforesaid therapy, such as the presence of an infection caused by periodontal disease or peri-apical lesions. The aim of this study was to evaluate the clinical success of implants placed in fresh extraction sockets which showed clinical signs of periodontal disease. MATERIALS AND METHODS: Twenty patients (13 males and 7 females) aged 24 to 65 were included in this study. After the initial examination and the treatment planning, all of the patients selected for the study underwent the periodontal treatment deemed necessary to facilitate wound healing. All the 20 teeth were extracted due to an infection. The second stage surgery was performed 4 months after the initial procedure. The following clinical parameters were evaluated for each patient at the time of implant placement and at the end of the 12 month follow-up period: Attachment level (AL), presence or absence of mobility, presence or absence of pain, presence or absence of suppuration. The bone level was measured as the distance from the implant shoulder to the first bone implant contact (Distance Bone Implant) (DIB) by periapical radiographs. The stability and health of the soft tissue was clinically evaluated by means of the plaque score. RESULTS: The healing period was uneventful for all the patients. All the implants were osseointegrated. At the end of the 12 month follow-up period, patients were asymptomatic and showed no signs of infection or bleeding when probed. The mean attachment level (AL) at the mid-buccal location per implant was 0.8 mm at the baseline and 0.9 mm at the end of the follow-up. The mean width of KM measured at the mid-buccal location per implant at the baseline and 1-year visits was 3.7+\-0.4 mm and 3.3+\-0.5 mm respectively. The mean Attachment level measured at the mid-buccal location per implant was 0.8 mm at the baseline and 0.9 mm at the end of the follow-up. The pariapical radiographs, obtained in a standardized manner, revealed a mean increase of 1 mm in the DIB value. At the 12-month-follow-up, the presence of plaque was observed in 44 of the 80 sites analyzed. CONCLUSIONS: On the basis of this study implants placed in fresh extraction sockets - which were affected by an infection- may be a valid operative technique, which leads to predictable results, if adequate pre- and postoperative care is taken.