Immediate placement of dental implants into debrided infected dentoalveolar sockets.
OBJECTIVE
To describe a protocol for the immediate placement of endosseous implants into debrided infected dentoalveolar sockets.


METHODS
A total of 30 implants were immediately placed into debrided infected sites in 20 patients. The pathology at the receptacle dentoalveolar sockets varied, and included subacute periodontal infection, perio-endo infection, chronic periodontal infection, chronic periapical lesion, and a periodontal cyst. The immediate placement protocol emphasized the meticulous debridement of the infected tissues in combination with peripheral ostectomy of the alveoli. Guided bone regeneration was accomplished to support bony healing of alveolar defects surrounding the implantation site. Pre- and postsurgical antibiotic therapy was administered.


RESULTS
All implants but 1 were osseointegrated and functional when followed up after 12 to 72 months. One implant was mobile after its immediate restoration and was removed. Complications were related to the use of guided bone regeneration. Deficiency of the attached gingiva was noted in 1 case. The treatment approach is illustrated in 2 anterior maxilla cases with 3-year follow-up.


CONCLUSIONS
Successful immediate implantation in debrided infected alveoli depends on the complete removal of all contaminated tissue and the controlled regeneration of the alveolar defect. With this proposed clinical approach, experienced clinicians may consider immediate implants as a viable treatment option in patients presenting with dentoalveolar infections.
Casap
Nardy
N
Department of Oral and Maxillofacial Surgery, Hebrew University-Hadassah, Faculty of Dental Medicine, Jerusalem, Israel. nard@md.huji.ac.il
Zeltser
Chassiel
C
Wexler
Alon
A
Tarazi
Eyal
E
Zeltser
Rephael
R
D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000601:surgery / Q000628:therapy*; D001861:Bone Regeneration; D018786:Bone Substitutes; D002985:Clinical Protocols; D003646:Debridement; D003758:Dental Implantation, Endosseous / Q000379:methods*; D005260:Female; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D008903:Minerals; D010485:Periapical Periodontitis / Q000601:surgery / Q000628:therapy*; D010510:Periodontal Diseases / Q000601:surgery / Q000628:therapy*; D020390:Tooth Socket / Q000601:surgery*; D016896:Treatment Outcome
C077540:Bio-Oss; D018786:Bone Substitutes; D008567:Membranes, Artificial; D008903:Minerals