Fig. 2. Intraoral radiograph of an immediately placed post-extractive dental implant with a full contour zirconia restoration after 1 year (same patient as in Fig. 1)
Fig. 2. Intraoral radiograph of an immediately placed post-extractive dental implant with a full contour zirconia restoration after 1 year (same patient as in Fig. 1)
Fig. 1. Pre-operative panoramic radiograph of a failing molar in position 36
Fig. 1. Pre-operative panoramic radiograph of a failing molar in position 36
Agreement percentage (n = 11)
Presence of shame
0.0
Self-confidence has decreased
0.0
Evades eating with the implant
9.1
The ability to chew has decreased
0.0
Implant influences speech
0.0
Implant influences taste
0.0
Not satisfied with the colour of the crown
0.0
Not satisfied with the form of the crown
0.0
Not satisfied with ...
Bone change (mm)n = 11mean (SD)− 0.17 mm (0.73)> − 2.0 to − 1.51 (9.1)> − 1.5 to − 1.00 (0.0)> − 1.0 to − 0.52 (18.2)> − 0.5 to 0.04 (36.4)> 0.0 to 0.52 (18.2)> 0.5 to 1.02 (18.2)Table 4 Mean value, standard deviation, and frequency distribution (percentages) of marginal bone change between 1 month after restoration placement (T1) and 1 year in ...
Bone level (mm)n = 15Mean (SD)− 0.94 mm (0.54)> − 2.5 to − 2.01 (6.7)> − 2.0 to − 1.52 (13.3)> − 1.5 to − 1.04 (26.7)> − 1.0 to − 0.55 (33.3)> − 0.5 to 0.03 (20.0)Table 3 Mean value, standard deviation, and frequency distribution (percentages) of marginal bone level at 1 month after restoration placement (T1)
T1 (n = 15)T12 (n = 11)Plaque indexScore 0, 15 (100%)Score 0, 11 (100%)Calculus indexScore 0, 15 (100%)Score 0, 11 (100%)Gingival indexScore 0, 15 (100%)Score 0, 11 (100%)Bleeding indexScore 0, 15 (100%)Score 0, 10 (91%)Score 1, 1 (9%)Probing depth in mm (sd)2.0 (0.9)1.9 (0.8)Table 2 Frequencies and percentages of plaque index scores (possible score 0–3), calculus index scores (possibl...
Mean age in years (sd, minimum-maximum)
57 (6.6, 44–67)
Gender (number male/female)
6/9
Reason of failure (severe caries/crown fracture/root fracture)
3/6/6
Implant position (maxilla/mandible)
7/8
Implant position (in between teeth/no tooth distally)
11/4
Table 1 Baseline characteristics of the study group
Meijer, H.J.A., Raghoebar, G.M. Immediate implant placement in molar extraction sites: a 1-year prospective case series pilot study. Int J Implant Dent 6, 3 (2020). https://doi.org/10.1186/s40729-019-0201-7
Download citation
Received: 29 October 2019
Accepted: 11 December 2019
Published: 12 February 2020
DOI: https://doi.org/10.1186/s40729-019-0201-7
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This clinical study was conducted in accordance with the World Medical Association Declaration of Helsinki (version VI, 2002). The Medical Ethical Committee of the University Medical Center Groningen considered this case series study not subject to the Medical Research Involving Human Subjects Act (Number M15.184100). The study was registered at the Netherlands Trial Register (Number NL8117). Afte...
Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, PO Box 30.001, NL-9700 RB, Groningen, The Netherlands
Henny J. A. Meijer & Gerry M. Raghoebar
Department of Implant Dentistry, University Medical Center Groningen, Groningen, The Netherlands
Henny J. A. Meijer
You can also search for this author in PubMed Google Scholar
You can also search for this author in...
An unrestricted grant from Nobel Biocare Services AG funded the 1-year clinical study; implant materials were provided (study code: 2015-1365).
Tallarico M, Xhanari E, Pisano M, Gatti F, Meloni SM. Molar replacement with 7 mm-wide diameter implants: to place the implant immediately or to wait 4 months after socket preservation? 1 year after loading results from a randomised controlled trial. Eur J Oral Implantol. 2017;10:169–78.
Checchi V, Felice P, Zucchelli G, Barausse C, Piattelli M, Pistilli R, Grandi G, Esposito M. Wide diameter i...
Hamouda NI, Mourad SI, El-Kenawy MH, Maria OM. Immediate implant placement into fresh extraction socket in the mandibular molar sites: a preliminary study of a modified insertion technique. Clin Implant Dent Relat Res. 2015;17(Suppl 1):e107–16. https://doi.org/10.1111/cid.12135.
Demircan S, Çankaya AB. Is immediate implant placement possible in the maxillary molar area? An anatomical study. Qu...
Gallucci GO, Hamilton A, Zhou W, Buser D, Chen S. Implant placement and loading protocols in partially edentulous patients: a systematic review. Clin Oral Implants Res. 2018;29(Suppl 16):106–34. https://doi.org/10.1111/clr.13276.
Slagter KW, Den Hartog L, Bakker NA, Vissink A, Meijer HJA, Raghoebar GM. Immediate placement of dental implants in the esthetic zone: a systematic review and pooled a...
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
Within the limitations of this study, it has been demonstrated that immediate placement of regular diameter implants in molar post-extraction sites of maxilla and mandible resulted in a high implant failure rate during a 1-year follow-up period.
In an attempt to incorporate the concept of patient engagement, this study investigated the patients’ satisfaction with the rehabilitated posterior region by assessing specific patient-centred outcomes. This was done by the patients filling out the established questionnaire 1 year after restoration placement [26, 27]. All the questioned outcome measures showed high patient satisfaction which is...
The mean marginal bone level was 0.94 mm below the neck of the implant at 1 month after restoration placement (T1). The optimal position of the peri-implant bone after a maturation period should be at the same level as the neck of the implant. This means that part of the biological width of the present study, which is acting as a barrier, was in contact with the implant surface roughness and w...
Immediate placement of regular diameter implants in molar post-extraction sites of the maxilla and mandible resulted in a high implant failure rate during a 1-year follow-up period.
The implant survival rate was 73.3% after 1 year in function. The performance of immediate placements in post-extraction sites was also analysed in the Cafiero et al., Atieh et al., Tallarico et al., and Checchi et a...
All 15 consecutive patients eligible to join the study on the basis of the inclusion and exclusion criteria agreed to participate in this study. The patient characteristics are depicted in Table 1. All implant-supported restorations had natural antagonistic teeth. Four of the 15 patients treated had a mobile implant, which had to be removed (in two patients 3 months after crown placement and in...
Radiographs were taken and evaluated 1 month and 12 months after restoration placement using a parallel technique, with an X-ray holder for periapical radiographs. They were analysed using a specially designed computer software to perform linear measurements on digital radiographs. The calibration was carried out in the vertical plane of each radiograph by using the known distance of the implan...
An impression was made at implant level 2 weeks after the second stage of the surgery in order to fabricate a single crown. A definitive full-zirconia crown (yttria-stabilized zirconium oxide) with an angulated screw channel (NobelProcera FCZ Implant Crown, NobelBiocare AB) was manufactured in the determined colour at a centralized milling facility (NobelProcera Service Center, Mahwah, NJ, USA) a...
All patients referred to the Department of Oral and Maxillofacial Surgery (University of Groningen, University Medical Hospital), from January 2016 to July 2017, for single-tooth implant therapy in the maxillary and mandibular posterior region were considered for inclusion. The following inclusion criteria were applied:
One failing first or second molar in the maxilla or mandible;
Sufficient bon...
Implant placement and loading protocols are changing [1]. There is a growing tendency to place single tooth implants immediately after the extraction of a failing tooth, especially in the maxillary aesthetic region, and preferably combined with immediate provisionalization [2,3,4,5,6]. This tendency is related to evolving society factors, including more demanding patients and a wish for direct tre...
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.
Fifteen consecutive patients with a single failing molar in the maxilla or mandible, and presenting enough bo...
Fig. 2. Intraoral radiograph of an immediately placed post-extractive dental implant with a full contour zirconia restoration after 1 year (same patient as in Fig. 1)
Fig. 2. Intraoral radiograph of an immediately placed post-extractive dental implant with a full contour zirconia restoration after 1 year (same patient as in Fig. 1)
Fig. 1. Pre-operative panoramic radiograph of a failing molar in position 36
Fig. 1. Pre-operative panoramic radiograph of a failing molar in position 36
Agreement percentage (n = 11)Presence of shame0.0Self-confidence has decreased0.0Evades eating with the implant9.1The ability to chew has decreased0.0Implant influences speech0.0Implant influences taste0.0Not satisfied with the colour of the crown0.0Not satisfied with the form of the crown0.0Not satisfied with the colour of the mucosa around the crown0.0Not satisfied with the form of the muc...
Bone change (mm)n = 11mean (SD)− 0.17 mm (0.73)> − 2.0 to − 1.51 (9.1)> − 1.5 to − 1.00 (0.0)> − 1.0 to − 0.52 (18.2)> − 0.5 to 0.04 (36.4)> 0.0 to 0.52 (18.2)> 0.5 to 1.02 (18.2)Table 4 Mean value, standard deviation, and frequency distribution (percentages) of marginal bone change between 1 month after restoration placement (T1) and 1 year in ...
Bone level (mm)n = 15Mean (SD)− 0.94 mm (0.54)> − 2.5 to − 2.01 (6.7)> − 2.0 to − 1.52 (13.3)> − 1.5 to − 1.04 (26.7)> − 1.0 to − 0.55 (33.3)> − 0.5 to 0.03 (20.0)Table 3 Mean value, standard deviation, and frequency distribution (percentages) of marginal bone level at 1 month after restoration placement (T1)
T1 (n = 15)T12 (n = 11)Plaque indexScore 0, 15 (100%)Score 0, 11 (100%)Calculus indexScore 0, 15 (100%)Score 0, 11 (100%)Gingival indexScore 0, 15 (100%)Score 0, 11 (100%)Bleeding indexScore 0, 15 (100%)Score 0, 10 (91%)Score 1, 1 (9%)Probing depth in mm (sd)2.0 (0.9)1.9 (0.8)Table 2 Frequencies and percentages of plaque index scores (possible score 0–3), calculus index scores (possibl...
Mean age in years (sd, minimum-maximum)57 (6.6, 44–67)Gender (number male/female)6/9Reason of failure (severe caries/crown fracture/root fracture)3/6/6Implant position (maxilla/mandible)7/8Implant position (in between teeth/no tooth distally)11/4Table 1 Baseline characteristics of the study group
Meijer, H.J.A., Raghoebar, G.M. Immediate implant placement in molar extraction sites: a 1-year prospective case series pilot study. Int J Implant Dent 6, 3 (2020). https://doi.org/10.1186/s40729-019-0201-7
Download citation
Received: 29 October 2019
Accepted: 11 December 2019
Published: 12 February 2020
DOI: https://doi.org/10.1186/s40729-019-0201-7
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This clinical study was conducted in accordance with the World Medical Association Declaration of Helsinki (version VI, 2002). The Medical Ethical Committee of the University Medical Center Groningen considered this case series study not subject to the Medical Research Involving Human Subjects Act (Number M15.184100). The study was registered at the Netherlands Trial Register (Number NL8117). Afte...
Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, PO Box 30.001, NL-9700 RB, Groningen, The Netherlands
Henny J. A. Meijer & Gerry M. Raghoebar
Department of Implant Dentistry, University Medical Center Groningen, Groningen, The Netherlands
Henny J. A. Meijer
You can also search for this author in PubMed Google Scholar
You can also search for this author in...
An unrestricted grant from Nobel Biocare Services AG funded the 1-year clinical study; implant materials were provided (study code: 2015-1365).
Tallarico M, Xhanari E, Pisano M, Gatti F, Meloni SM. Molar replacement with 7 mm-wide diameter implants: to place the implant immediately or to wait 4 months after socket preservation? 1 year after loading results from a randomised controlled trial. Eur J Oral Implantol. 2017;10:169–78.
Checchi V, Felice P, Zucchelli G, Barausse C, Piattelli M, Pistilli R, Grandi G, Esposito M. Wide diameter i...
Hamouda NI, Mourad SI, El-Kenawy MH, Maria OM. Immediate implant placement into fresh extraction socket in the mandibular molar sites: a preliminary study of a modified insertion technique. Clin Implant Dent Relat Res. 2015;17(Suppl 1):e107–16. https://doi.org/10.1111/cid.12135.
Demircan S, Çankaya AB. Is immediate implant placement possible in the maxillary molar area? An anatomical study. Qu...
Gallucci GO, Hamilton A, Zhou W, Buser D, Chen S. Implant placement and loading protocols in partially edentulous patients: a systematic review. Clin Oral Implants Res. 2018;29(Suppl 16):106–34. https://doi.org/10.1111/clr.13276.
Slagter KW, Den Hartog L, Bakker NA, Vissink A, Meijer HJA, Raghoebar GM. Immediate placement of dental implants in the esthetic zone: a systematic review and pooled a...
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
Within the limitations of this study, it has been demonstrated that immediate placement of regular diameter implants in molar post-extraction sites of maxilla and mandible resulted in a high implant failure rate during a 1-year follow-up period.
In an attempt to incorporate the concept of patient engagement, this study investigated the patients’ satisfaction with the rehabilitated posterior region by assessing specific patient-centred outcomes. This was done by the patients filling out the established questionnaire 1 year after restoration placement [26, 27]. All the questioned outcome measures showed high patient satisfaction which is...
The mean marginal bone level was 0.94 mm below the neck of the implant at 1 month after restoration placement (T1). The optimal position of the peri-implant bone after a maturation period should be at the same level as the neck of the implant. This means that part of the biological width of the present study, which is acting as a barrier, was in contact with the implant surface roughness and w...
Immediate placement of regular diameter implants in molar post-extraction sites of the maxilla and mandible resulted in a high implant failure rate during a 1-year follow-up period.
The implant survival rate was 73.3% after 1 year in function. The performance of immediate placements in post-extraction sites was also analysed in the Cafiero et al., Atieh et al., Tallarico et al., and Checchi et a...
All 15 consecutive patients eligible to join the study on the basis of the inclusion and exclusion criteria agreed to participate in this study. The patient characteristics are depicted in Table 1. All implant-supported restorations had natural antagonistic teeth. Four of the 15 patients treated had a mobile implant, which had to be removed (in two patients 3 months after crown placement and in...
Radiographs were taken and evaluated 1 month and 12 months after restoration placement using a parallel technique, with an X-ray holder for periapical radiographs. They were analysed using a specially designed computer software to perform linear measurements on digital radiographs. The calibration was carried out in the vertical plane of each radiograph by using the known distance of the implan...
An impression was made at implant level 2 weeks after the second stage of the surgery in order to fabricate a single crown. A definitive full-zirconia crown (yttria-stabilized zirconium oxide) with an angulated screw channel (NobelProcera FCZ Implant Crown, NobelBiocare AB) was manufactured in the determined colour at a centralized milling facility (NobelProcera Service Center, Mahwah, NJ, USA) a...
All patients referred to the Department of Oral and Maxillofacial Surgery (University of Groningen, University Medical Hospital), from January 2016 to July 2017, for single-tooth implant therapy in the maxillary and mandibular posterior region were considered for inclusion. The following inclusion criteria were applied:
One failing first or second molar in the maxilla or mandible;
Sufficient bon...
Implant placement and loading protocols are changing [1]. There is a growing tendency to place single tooth implants immediately after the extraction of a failing tooth, especially in the maxillary aesthetic region, and preferably combined with immediate provisionalization [2,3,4,5,6]. This tendency is related to evolving society factors, including more demanding patients and a wish for direct tre...
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.
Fifteen consecutive patients with a single failing molar in the maxilla or mandible, and presenting enough bo...
Fig. 7. Multiple graphs comparing A-B distance (height bone) (a) and the C-D distance (tissue thickness) (b) among different groups. Differences between groups were assessed by Dunn’s multiple comparison test (*P
Fig. 6. Graph comparing the data of buccal (B) and lingual (L) measured the C-D distance (tissue thickness). Group 1 = implant installed in fresh extraction and submerged; group 2 = implants in fresh extraction and immediately exposed; group 3 = implants installed in healed site and submerged; and group 4 = implants in healed site and immediately exposed
Fig. 6. Graph comparing the data of bu...
Fig. 5. Graph comparing the data of buccal (B) and lingual (L) measured the A-B distance (bone height). Group 1 = implant installed in fresh extraction and submerged; group 2 = implants in fresh extraction and immediately exposed; group 3 = implants installed in healed site and submerged; and group 4 = implants in healed site and immediately exposed
Fig. 5. Graph comparing the data of buc...
Fig. 4. Images of groups 3 and 4 representing the implants place in healed alveolar sites. Picrosirius red staining. Original magnification × 4
Fig. 4. Images of groups 3 and 4 representing the implants place in healed alveolar sites. Picrosirius red staining. Original magnification × 4
Fig. 3. Images of groups 1 and 2 representing the implants place in fresh sockets sites. Picrosirius red staining. Original magnification × 4
Fig. 3. Images of groups 1 and 2 representing the implants place in fresh sockets sites. Picrosirius red staining. Original magnification × 4
Fig. 2. Parameters measured in each group. Crestal bone loss is the distance between the implant collar (A) and the first bone contact of the crestal bone (B) = A-B bone height; and, the tissue thickness that is the distance from the implant collar (C) to the more external portion of the tissues (D) = C-D tissue thickness. Picrosirius red staining. Original magnification × 16
Fig. 2. Param...
Fig. 1. Image of the implant (a) and surface (b) used in the present study
Fig. 1. Image of the implant (a) and surface (b) used in the present study
Group
1
2
3
4
Friedman test
...
Tissue thickness (C-D distance in mm)
Buccal
Lingual
Group 1
Group 2
Group 3
...
Crestal bone loss (A-B distance in mm)
Buccal
Lingual
Group 1
Group 2
Group 3
...
Gehrke, S.A., Bragança, L.K., Velasco-Ortega, E. et al. Evaluation of dimensional behavior of peri-implant tissues in implants immediately exposed or submerged in fresh extraction and healed sites: a histological study in dogs.
Int J Implant Dent 4, 5 (2018). https://doi.org/10.1186/s40729-018-0120-z
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Received: 02 October 2017
Accepted: 10 January 2018
Pu...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Sergio Alexandre Gehrke, Leana Kathleen Bragança, Eugenio Velasco-Ortega, and Jose Luis Calvo-Guirado declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Biotecnos Research Center, Calle Cuareim, 1483, CP: 11.100, Montevideo, Uruguay
Sergio Alexandre Gehrke
University Catholica San Antonio de Murcia (UCAM), Murcia, Spain
Sergio Alexandre Gehrke
Implant Dentistry, Seville University, Seville, Spain
Leana Kathleen Bragança
General Dentistry, Seville University, Seville, Spain
Eugenio Velasco-Ortega
Implant Dentistry Master, Seville Universit...
Trisi P, Lazzara R, Rao W, Rebaudi A. Bone-implant contact and bone quality: evaluation of expected and actual bone contact on machined and osseotite implant surfaces. Int J Periodontics Restorative Dent. 2002;22(6):535–45.
Calvo-Guirado JL, Ortiz-Ruiz AJ, Negri B, López-Marí L, Rodriguez-Barba C, Schlottig F. Histological and histomorphometric evaluation of immediate implant placement on a d...
Spray JR, Black CG, Morris HF, Ochi S. The influence of bone thickness on facial marginal bone response: stage 1 placement through stage 2 uncovering. Ann Periodontol. 2000;5(1):119–28.
Bornstein MM, Lussi A, Schmid B, Belser UC, Buser D. Early loading of nonsubmerged titanium implants with a sandblasted and acid-etched (SLA) surface: 3-year results of a prospective study in partially edentulou...
Lang NP, Pun L, Lau KY, Li KY, Wong MC. A systematic review on survival and success rates of implants placed immediately into fresh extraction sockets after at least 1 year. Clin Oral Implants Res. 2012;23(Suppl 5):39–66.
Bornstein MM, Valderrama P, Jones AA, Wilson TG, Seibl R, Cochran DL. Bone apposition around two different sandblasted and acid-etched titanium implant surfaces: a histomorpho...
Chen ST, Buser D. Esthetic outcomes following immediate and early implant placement in the anterior maxilla—a systematic review. Int J Oral Maxillofac Implants. 2014;29(Suppl):186–215.
Berberi AN, Tehini GE, Noujeim ZF, Khairallah AA, Abousehlib MN, Salameh ZA. Influence of surgical and prosthetic techniques on marginal bone loss around titanium implants. Part I: immediate loading in fresh ex...
Botticelli D, Berglundh T, Lindhe J. Hard-tissue alterations following immediate implant placement in extraction sites. J Clin Periodontol. 2004;31(10):820–8.
Araújo MG, Lindhe J. Dimensional ridge alterations following tooth extraction. An experimental study in the dog. J Clin Periodontol. 2005;32(2):212–8.
Araújo MG, Sukekava F, Wensström JL, Lindhe J. Ridge alterations following implan...
Within the limitations of this study, our findings suggest that the crestal bone height is larger when implants are inserted in healed areas in comparison with implants installed in fresh extraction sites. Moreover, significant differences were found between non-exposed and immediately exposed implants with regards to crestal bone height position, and higher thickness tissue values in the groups o...
New studies are needed to define the influence of other surface compositions and neck configurations for implants placed in fresh extraction sockets with/or without submerged and the influence of abutment change on crestal bone stabilization during the remodeling process. These would appear to be important factors for improving peri-implant bone and soft tissue stability and clinical outcomes, inc...
In the present study, the implants were positioned in the crestal bone level, by following Bornstein et al. [34, 35] which reported that the implants are often inserted within the bone crest. Tomasi et al. [36] in a clinical trial observed that the implant position conditioned the amount of buccal crest resorption. Moreover, the thickness of the buccal bone plate and the tridimensional positioning...
The immediate implants in fresh sockets have demonstrated a great success rate [18, 22,23,24]. However, the removal of a single tooth followed by immediate placement of an implant results in marked alterations of the ridge in the horizontal as well as in the vertical dimension. The early phases of tissue integration in immediate post-extraction implants have been well documented [1, 25, 26]. The i...
The surgical sites healed uneventfully. All animals presented appropriate healing during the first week following the surgical procedure. Post-surgical inspections for 2 weeks post-operatively indicated the absence of infection or inflammation. All implants presented osseointegration after the proposed period and were available for histological analysis.
Direct contact was observed between livin...
A power analysis was conducted to determine appropriate sample size; although it was determined that 6 samples from each group would generate a 95% confidence limit (G3Power), 10 samples were proposed for each situation to increase the level of significance.
The hemimandibles were removed with care to preserve the integrity of both peri-implant hard and soft tissues, washed in saline solution and fixed in 10% buffered formalin, and sent for processing at the Laboratory of Ucam-Biotecnos (Murcia, Spain). Specimens were dehydrated in ascending series of alcohol rinses and embedded in a glycol methacrylate resin (Technovit 7200 VLC; Kulzer, Wehrheim, Ger...
A total of 40 implants were installed (ICI implant, Galimplant, Sarria, Spain), with 3.5 mm in diameter by 10 mm in length. Eight implants in each dog, half per hemimandible. The surface treatment of this implant model is developed by blasting with three different granulometries of Al2O3 and pickling using a hydrofluoric solution (HF) at low temperature and short time, which aims to remove any t...
Then, the good results were obtained with both techniques (implants placed into fresh alveolus and implants non-submerged); these have been joined together with the objective to reduce the time of the treatment. However, the esthetic results can directly influence by the peri-implant tissue dimension (vertical or horizontal) and position in relationship of the cervical implant portion. In this way...
After the tooth loss, there is a progressive involution of the alveolar bone both in the horizontal and the vertical dimensions [1, 2]. Moreover, the most rapid reduction in the alveolar bone after tooth extraction occurs during the first 3 months [3, 4]. Implants immediately positioned in alveolus after the surgical extraction of the tooth exhibit a success ranging from 92.7 to 98.0% [5]. Some a...
The aim of this study was to compare histologically the dimensional behavior of peri-implant tissues during osseointegration of immediately exposed or submerged implant placement in fresh extraction and healed sites.
Four fresh extraction and four delayed implant sites were placed in each hemimandible of five dogs at the bone crest level. In 2 implants of each side were installed a healing abutme...
Figure 49. Dimensional ridge alternation : 8 weeks
At 8 weeks after tooth extraction, the entrance to the extraction site is bridged with cortical bone. The woven bone in the socket is replaced with bone marrow and some trabeculae of lamellar bone. At the crests of the buccal and lingual cortical plates, there are signs of ongoing bone resorption.
Figure 31. Mandibular molar extraction
However, hard tissue formation within extraction sockets is highly variable in humans.
Figure 29. Day 180 : large marrow spaces
After 180 days of healing, beneath the marginal cortical bone at the entrance of the socket as denoted by the arrow, most of the socket is filled with trabecular bone that includes large marrow spaces. The bone is characterized by a limited number of trabeculae of lamellar bone. The bone marrow contains large numbers of adipocytes but only a few inflam...
Figure 28. Day 120 : cortical bone & trabecular bone
At 120 days of healing, the entrance of the socket, denoted with an arrow, has become reinforced by layers of cortical bone that are deposited over the previously formed woven bone.
Figure 27. At 30 days of healing, a significant part of the extraction socket is filled with newly formed bone.
At 30 days of healing, a significant part of the extraction socket is filled with newly formed bone. This bone contains a large number of primary osteons and is continuous with the original bone of the socket walls. In some areas, the process of modeling and remodeling of the newly ...
Figure 26. Day 14: woven bone & connective tissue
After 14 days of healing woven bone, which appears as a loose, unstructured network of bone, has started to fill the socket except in the central region, where significant amounts of the provisional connective tissue matrix still remain. This is because the woven bone forms first at the periphery of the socket and gradually extends from the wa...
Figure 25. Day 7: Provisional matrix & osteoclasts
After 1 week of healing, the wound in the extraction site has significantly changed. In the central and apical part of the socket, large areas of the coagulum have been replaced with a provisional connective tissue matrix, which is lightly stained in the histologic section. Regions of darker-staining granulation tissue can still be seen. This...
Figure 24. Day 3: blood coagulation, inflammatory cells, granulation tissue
At the end of this initial healing period, small segments of the coagulum are replaced by a highly vascularized granulation tissue and an inflammatory cell infiltrate that is stained dark red/blue.
Figure 23. summary of biological events on third day after extraction
On day 3, the socket is filled with a blood coagulum comprised of red blood cells and platelets trapped in a fibrin network together with isolated inflammatory cells such as neutrophils. Close to the bundle bone, mesenchymal cells, severed periodontal fibers, and dilated vascular units can be observed.
Figure 22. Day 1: Blood coagulation and inflammatory cells
Hard and soft tissue composition in the extraction socket during longer healing periods was documented in a study by Cardaropoli and coworkers, in which the entire healing cascade after tooth extraction was evaluated in a dog model. The following images are histologic specimens representing the stages of healing observed in their stud...
Figure 21. Histologic sequence of healing
The healing of an extraction socket is characterized by a sequence of histologic events taking place in four distinct stages: inflammation, fibroplasia, mineralization, and remodeling. This cascade of events in the extraction socket is similar to intramembranous bone formation in other types of osseous defects and begins with the inflammation stage. D...
Figure 18. Extraction socket wall
The buccal bone plate is usually thin, less than 1 mm, especially in the anterior dentition, and it consists mainly of bundle bone. On the contrary, the lingual or palatal wall of the socket is usually thicker than its buccal counterpart, and some trabecular bone may be present.
Figure 17. Extraction socket
The extraction socket is a term used to describe the tissues remaining after tooth removal. The outer walls of the extraction socket consist mainly of cortical bone.
Figure 1. Tooh extraction
Figure 2. Post-extraction socket
Following tooth extraction, a well-described process of wound healing takes place in the extraction socket. A series of physiological events occur, resulting in wound healing and bone regeneration within the socket. Bone resorption results in external changes to the alveolar ridge. ...