Immediate mandibular rehabilitation with endosseous implants: simultaneous extraction, implant placement, and loading.
OBJECTIVE
This report of a clinical patient series indicates the relative safety and illustrates the procedures involved in the extraction of remaining teeth followed by immediate implant placement and loading with a simple acrylic resin fixed denture.


METHODS
Ten consecutive patients who selected tooth extraction and implant-supported fixed denture rehabilitation of the mandible were treated using a 1-visit approach for extraction, implant placement, and restoration. Healthy individuals (10 women) were treated under local anesthesia. Fifty-four implants were placed in 10 patients. Five or 6 Astra Tech implants (11 or 13 mm long) were placed into the edentulous parasymphyseal region of the mandible. Four to 6 implants (48 of 54) were immediately loaded by the fabrication of a simple acrylic resin fixed denture. The criterion for loading was clinical judgment of primary stability, ie, the absence of axial or lateral mobility with physical resistance to rotation. Patients were recalled at 1, 3, and 12 weeks. At 12 weeks, impressions were made for the fabrication of a screw-retained fixed denture. The fixed dentures were completed using conventional fabrication and prosthetic techniques.


RESULTS
After a period of 6 to 18 months, all 54 implants had survived and were considered 100% successful by independent testing of mobility and radiographic evidence of osseointegration. There were no surgical complications. Fracture and debonding of the acrylic resin provisional denture occurred for 1 patient during the first 12 weeks of treatment.


CONCLUSIONS
Advantages to extraction with simultaneous replacement include the maintenance of vertical dimension, elimination of reline procedures and interim denture therapy, and potential improvement of soft tissue healing.


CONCLUSIONS
This therapeutic approach simplifies patient care without apparent additional risk.
Department of Prosthodontics, University of North Carolina School of Dentistry Bone Biology, Chapel Hill 27599, USA. Lyndon_Cooper@dentistry.unc.edu
Lyndon F
LF
Cooper
Amin
A
Rahman
John
J
Moriarty
Nancy
N
Chaffee
Debra
D
Sacco
D000328:Adult; D000368:Aged; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D017268:Dental Prosthesis Retention; D019094:Dental Prosthesis, Implant-Supported; D003830:Denture, Partial, Fixed; D003831:Denture, Partial, Immediate; D017050:Episode of Care; D005260:Female; D006801:Humans; D007575:Jaw, Edentulous / Q000534:rehabilitation*; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D014081:Tooth Extraction; D020390:Tooth Socket / Q000601:surgery; D016474:Weight-Bearing
D015921:Dental Implants