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Dental implants placed immediately into single-rooted extraction sockets have been well documented over the years. More recently there has been an increase in the publications looking at immediate implants in molar extraction sites. The advantages of reducing treatment times and limiting the number of surgeries helps with patient acceptance and is also advantageous for the surgeon. There are also clinical advantages of improved pink aesthetic scores and reduced food packing for the definitive restorations. This case report demonstrates the techniques used in achieving a predictable outcome in immediate molar implant treatment.
CPD/Clinical Relevance:
The advantages and the methods used for placing an implant into a molar extraction socket and restoring it are discussed.
Article
Implants placed immediately into molar extraction sites were first documented in the literature over 30 years ago1 and more recent systematic reviews have shown their success rates to be comparable to that of delayed implant placements.2,3,4 While the benefits of immediate implants in the anterior zone may be obvious, where aesthetically critical sites benefit from quicker treatments and improved pink aesthetic score (PES) by maintaining the soft tissue profiles;5 prevention of soft tissue collapse in molar sites can also be beneficial in preventing food packing, which is a common problem around molar implant crowns.
Immediate molar sites have been classified into three different types6 depending on how much septal bone remains between the roots. If the implant can be fully encased into the septal bone, this is a type A socket. If, however, part of the implant is exposed, but is primarily supported by the septal bone, this is a type B socket. Where there is no septal bone, and a wide diameter implant must be used to engage the buccal and palatal bone, then this is a type C socket. Traditional engagement, with the implant 3–5 mm apical to the socket to achieve primary stability, is not often possible in molar sites owing to the presence of anatomical structures (namely the inferior dental canal and the maxillary sinus).
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