Looking to incorporate immediate implant placements in your practice? This in-depth guide will walk you through the essentials, from atraumatic extraction to managing socket healing.
Implant dentistry has evolved rapidly, with immediate implants emerging as a favored approach to streamline treatments and preserve bone. This is because when immediate implants are executed correctly they reduce treatment time significantly compared to delayed placements. Rather than extracting and waiting months for the site to heal, immediate implants allow for a single surgical step, followed by a period of healing. This means you can achieve predictable results and reduce bone resorption.
FACT: Studies have shown high success rates for immediate implants, with survival rates of up to 99%.
In molar regions, careful planning is essential. Use CBCT to assess bone quality and quantity and decide on primary stability strategies. One of the first decisions is whether to use a flap or flapless approach. Avoid raising a flap whenever possible to maintain blood supply and minimize surgical trauma.
Type A Socket: Has thick interradicular bone, allowing the implant to be housed entirely within. This makes primary stability easy to achieve.
Type B Socket: Shows thick interradicular bone with some gaps around the implant circumference. Despite the gaps, stability is attainable.
Type C Socket: Lacks interradicular bone or has a thin layer that must be removed. Here, a wider implant is used to engage the surrounding cortical plates.
For lower molars, segment the roots and remove them atraumatically. For maxillary molars, section into three parts using the “Mercedes cut” technique. Removing roots without causing excessive trauma preserves the buccal bone and helps avoid collapse.
After extraction, clear the socket of any soft tissue remnants and thoroughly irrigate the area. Then, drill for the implant placement, aiming for primary stability by engaging the surrounding bone.
Whether or not to graft depends on the case specifics and the gap distance between the implant and socket walls. Research indicates that grafting might not always be necessary, as the body can naturally fill smaller gaps with bone. However, grafting may be beneficial in aesthetic zones or where hygiene is a concern, like in posterior areas, to preserve bone and avoid tissue collapse.
Customized healing abutments support tissue stability and limit buccal bone resorption.
To create one:
Immediate implants in the molar region offer a predictable and efficient solution, allowing for faster treatments and better bone preservation. By carefully planning and executing the procedure, you can reduce complications and enhance outcomes. Learning these techniques is a journey, so start with simpler cases, and as your skills grow, tackle more complex scenarios. With the right approach and tools, you can confidently incorporate immediate implants into your practice.
Watch my full lecture on Immediate Implants in the Molar Region to learn more by clicking here.
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