Oral and Maxillofacial Surgery
Immediate placement of implants in periapical infected sites: A prospective randomized study in 50 patients

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Objective

To determine clinical success when implants are placed in chronic periapical infected sites.

Study design

Fifty patients (25 females, 25 males, mean age 39.7 ± 14.5 years) were included in this prospective controlled study. After randomization, 25 Frialit-2 Synchro implants were immediately placed (IP) after extraction, and 25 Frialit-2 Synchro implants were placed after a 3-month healing period (DP). Thirty-two implants were placed in the anterior maxilla and 18 implants were placed in the premolar region. Implant survival, mean Implant Stability Quotient (ISQ) values, gingival aesthetics, radiographic bone loss, and microbiologic characteristics of periapical lesions were evaluated for both groups.

Results

Overall, 2 implants belonging to the IP group were lost, resulting in a survival rate of 92% for IP implants versus 100% for DP implants. Mean ISQ, gingival aesthetics and radiographic bone resorption, and periapical cultures were not significantly different with the IP and DP implants.

Conclusions

Immediate implant placement in chronic periapical lesions may be indicated.

Section snippets

Patients and methods

The present study was performed within the guidelines of the Helsinki Declaration for biomedical research involving human subjects. The study was conducted at the department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam.

All patients were given emphasis-placed detailed explanations of the study protocol and were asked to sign surgical consent forms. The primary indication for placement of implants was a maxillary anterior or premolar single-tooth replacement. Fifty

Results

Fifty implants were placed in 50 patients. Mean age in female patients was 39.2 ± 16.1 years versus 40.2 ± 12.9 years for males (P = 0.8). The mean age in the immediate-placed implant group (IP) was 39.9 ± 16.2 years compared with 39.5 ± 12.9 for the delay-placed implants group (DP; P = 0.92). Figure 1 shows the length and the diameter of the implants in the 2 groups. In the IP group, larger diameter implants (5.5 and 6.5) were placed, compared with those placed in the DP group.

Thirty-two (64%)

Discussion

Immediate placement of endosseous implants into extraction sockets to reduce the process of alveolar bone resorption and treatment time has been propagated by several authors.1, 12 However, few clinical data are available on the immediate placement in chronic periapical infected sites. To our knowledge, the present study was the first controlled comparison between immediate and delayed placement of implants for replacement of teeth with periapical lesions. Some authors consider placement of

Conclusion

Within the limits of the present study, immediate placement of single tooth implants for replacement of teeth with periapical lesions was a predictable treatment. Implant success, mean ISQ, and radiographic bone level at 1-year follow-up were not related to the periapical microbial flora. However, a delayed implant protocol might be considered in the aesthetic zone due to the recession at the level of the mid-buccal gingiva.

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