Immediate/early function of Brånemark System TiUnite implants in fresh extraction sockets in maxillae and posterior mandibles: an 18-month prospective clinical study. Effect of Microthread Design on Marginal Bone Level Around Dental Implants Placed in Fresh Extraction Sockets Factors influencing ridge alterations following immediate implant placement into extraction sockets. Buccal bone deficiency in fresh extraction sockets: a prospective single cohort study. The Clinical Outcomes of Immediate Versus Delayed Restoration Procedures on Immediate Implants: A Comparative Cohort Study for Single-Tooth Replacement. Immediate and delayed implant placement into extraction sockets: a 5-year report. Marginal bone loss evaluation around immediate non-occlusal microthreaded implants placed in fresh extraction sockets in the maxilla: a 3-year study. Analysis of the socket bone wall dimensions in the upper maxilla in relation to immediate implant placement. A comparison of clinical outcomes for implants placed in fresh extraction sockets versus healed sites in periodontally compromised patients: a 1-year follow-up report. Comparison of radiographic and clinical outcomes following immediate provisionalization of single-tooth dental implants placed in healed alveolar ridges and extraction sockets. Immediate provisionalization of dental implants placed in healed alveolar ridges and extraction sockets: a 5-year prospective evaluation. Tapered, Double-Lead Threads Single Implants Placed in Fresh Extraction Sockets and Healed Sites of the Posterior Jaws: A Multicenter Randomized Controlled Trial with 1 to 3 Years of Follow-Up Three-years clinical outcome of immediate provisionalization of single Osseospeed(™) implants in extraction sockets and healed ridges. Immediate implantation in fresh extraction sockets. A controlled clinical and histological study in man. The clinical use of deproteinized bovine bone mineral on bone regeneration in conjunction with immediate implant installation. Immediate implant placement into fresh extraction sites with chronic periapical pathologic features combined with plasma rich in growth factors: preliminary results of single-cohort study. Alveolar ridge preservation with a free gingival graft in the anterior maxilla: volumetric evaluation in a randomized clinical trial. Immediate versus delayed loading of dental implants placed in fresh extraction sockets in the maxillary esthetic zone: a clinical comparative study. Immediately restored single implants in the aesthetic zone of the maxilla using a novel design: 1-year report. Preservation of peri-implant soft and hard tissues using platform switching of implants placed in immediate extraction sockets: a proof-of-concept study with 12- to 36-month follow-up. Immediate maxillary restoration of single-tooth implants using platform switching for crestal bone preservation: a 12-month study. Immediate provisionalisation of single post-extractive implants versus implants placed in healed sites in the anterior maxilla: 1-year results from a multicentre controlled cohort study. Immediate non-occlusal loading of immediate post-extractive versus delayed placement of single implants in preserved sockets of the anterior maxilla: 4-month post-loading results from a pragmatic multicentre randomised controlled trial.
BACKGROUND The advantages of placing implants in fresh extraction sockets and putting them in immediate/early function are many . A predicable protocol opens the possibility of performing a single surgical procedure , giving the patient a temporary prosthesis immediately , and minimizing the shrinkage of hard tissue and soft tissue recession . PURPOSE The aim of the present study was to develop a strict protocol for and to evaluate the feasibility of immediate/ early function on implants placed in fresh extraction sockets located in maxillae and posterior m and ibles , including defects around the implants treated according to a regenerative procedure . MATERIAL S AND METHODS Nineteen patients were treated after tooth extraction according to an immediate function protocol and were observed for 18 months . Fifty Mk IV TiUnite ( Nobel Biocare AB , Göteborg , Sweden ) implants were installed in partially edentulous areas in maxillae ( n = 17 ) and posterior m and ibles ( n = 5 ) . Implants were installed directly into the alveoli , and the temporary prostheses were connected immediately after surgery ( n = 11 ) or within 7 days , that is , an " early function " procedure ( n = 11 ) . Thirteen implants did not require any type of regenerative procedure , whereas the remaining 37 implants had filling with autogenous bone , 4 of which also had a resorbable membrane . St and ardized intraoral radiographs were taken for evaluation of marginal bone level , and 38 of the implants were systematic ally checked by resonance frequency analysis . RESULTS All patients were followed for 18 months , and none of the 50 implants failed . However , one implant showed signs of failure after 6 weeks , but once the occlusal load was removed , the implant regained its stability completely , no longer demonstrated symptoms , and could be used successfully for prosthetic rehabilitation . The mean value of the implant stability quotient was 60 at baseline ( range 45 - 75 ) and 63 after 6 months ( range 46 - 75 ) . The marginal bone resorption was 0.9 mm ( SD 1.1 mm ; n = 48 ) 18 months after implant insertion ( 1 year after final prosthesis ) . CONCLUSION The immediate placement of implants into fresh extraction sockets combined with immediate/early function procedures seems to be a safe and reliable procedure when using a strict protocol Purpose : This study was design ed to compare radiographically the effect of microthread on the coronal portion of the fixture on marginal bone level ( MBL ) around immediately placed dental implants in human subjects . Material and Methods : Forty-one roughened surface screw type Dentium oral implants ( Dentium ) were inserted in fresh extraction sockets of the anterior segment of maxilla of 30 patients . The implants were selected r and omly using either microthread design on coronal portion of the fixture ( Implantium ) ( test group ) or without microthread thread design ( Superline ) ( control group ) . MBL was measured using digital subtraction radiography technique after 3 , 6 , and 12 months . Results : At month 3 , the microthread groups have been associated with more marginal bone loss than the control group ( P = 0.04 ) . At months 6 and 12 , both groups had comparable bone levels ( P = 0.21 ) . Conclusion : The microthread design of the implant collar could not have a positive effect in maintaining the MBL around implants placed in fresh extraction socket in anterior maxilla AIM To identify factors that may influence ridge alterations occurring at the buccal aspect of the extraction site following immediate implant placement . MATERIAL AND METHODS In 93 subjects , single-tooth implants were placed immediately into extraction sockets in the maxilla ( tooth locations 15 - 25 ) . A series of measurements describing the extraction site were made immediately after implant installation and at re-entry , 16 weeks later . The implant sites were stratified according to four factors : ( i ) implant location ( anterior/posterior ) , ( ii ) cause of tooth extraction ( periodontitis/non-periodontitis ) , ( iii ) thickness of the buccal bone walls ( < or = 1 or > 1 mm ) and ( iv ) the dimension of the horizontal buccal gap ( < or = 1 or > 1 mm ) . RESULTS ( i ) The location where the implant was placed ( anterior/posterior ) as well as ( ii ) the thickness of the buccal bone crest and ( iii ) the size of the horizontal buccal gap significantly influenced the amount of hard tissue alteration that occurred during a 4-month period of healing . At implant sites in the premolar segment , the fill of the horizontal gap was more pronounced than in the incisor-canine segment , while the vertical crest reduction was significantly smaller . Furthermore , at sites where the buccal bone wall was thick ( > 1 mm ) and where the horizontal gap was large ( > 1 mm ) , the degree of gap fill was substantial . CONCLUSIONS The thickness of the buccal bone wall as well as the dimension of the horizontal gap influenced the hard tissue alterations that occur following immediate implant placement into extraction sockets OBJECTIVE The purpose of this prospect i ve single cohort study was to evaluate the use of xenograft and collagen membranes in treating full or partial buccal bone defects of fresh extraction sockets in the esthetic zone . MATERIAL S AND METHODS Thirty-three patients requiring tooth extraction in the anterior maxillary area and showing a complete or partial buccal bone plate deficiency ( more than 2 mm ) were consecutively enrolled and treated . Corticocancellous porcine bone and platelet-rich fibrin ( PRF ) with a collagen membrane were used to graft the extraction sockets , and the membranes were left exposed to the oral cavity with a secondary soft tissue healing . The outcome variables were as follows : width of keratinized mucosa , facial soft tissue levels , clinical bone changes ( measured with a clinical splint ) , implant and prosthesis failures , and peri-implant marginal bone changes . RESULTS All treated sites allowed the placement of implants ; the width of keratinized mucosa at the mid-facial aspect showed an increase of 2.3 mm 5 months after the grafting procedure , and its value was 3.2 ± 0.6 mm at 1-year follow-up . The mean values of the facial soft tissue level indicated an increase over time . The bone level showed an improvement of 0.8 ± 0.1 mm and 0.7 ± 0.1 mm at mesial and distal sites , respectively , when compared to the baseline measurements . Finally , in the palatal area , no bone changes were observed . No implant failed during the entire observation period . CONCLUSIONS Findings from this study showed that xenograft and PRF , used for ridge preservation of the extraction sockets with buccal bone plate dehiscence in the esthetic zone , can be considered effective in repairing bone defects before implant placement . The secondary soft tissue healing over the grafted sockets did not compromise bone formation ; moreover , the soft tissue level and the width of keratinized gingiva showed a significant improvement over time BACKGROUND Immediate implant placement into fresh extraction sockets is generally considered a reliable procedure that offers several clinical advantages . PURPOSE The primary aim of this study was to evaluate and compare the overall clinical outcomes of immediate and delayed restoration procedures for  implants placed in fresh extraction sockets by means of a flapless technique and resorbable membrane stabilizing a xenograft . Total costs and operating times were also compared . MATERIAL S AND METHODS In this prospect i ve cohort study , changes of marginal bone level , facial soft tissue ( ΔFST ) , and width of keratinized gingiva ( ΔWKG ) , in addition to the papilla index , underwent a pairwise comparison ; correlations with pristine buccal bone thickness were also investigated . RESULTS Although similar results were recorded for the two procedures , with a bone loss of -1.0 ± 0.5 mm and -0.9 ± 0.7 mm , respectively , for immediate and delayed restoration  , negative remodeling in the delayed restoration procedure was seen to occur from 4 to 12 months after implant placement . No significant differences were recorded between the two procedures in terms of ΔFST and ΔWKG . A loss of the papillary soft tissues before restoration , followed by a reestablishment after restoration , seemed to be verified for the delayed group , for which the papilla index went from the minimum of 0 at 4 months to a value of 2 at 24 months . Moreover , the immediate restoration procedure seemed to be more promising in terms of healing times and costs . CONCLUSION Immediate restoration of implants installed in fresh extraction sockets was at least as effective and safe as delayed restoration BACKGROUND As a complement to the earlier reported 3-year results from a prospect i ve multicenter study of immediate and delayed placement of implants into fresh extraction sockets , the 5-year results are reported . PURPOSE The purpose of this 5-year report was to evaluate the immediate and long-term success of implants placed into fresh extraction sockets , with respect to implant size and type , bone quality and quantity , implant position , initial socket depth , and reason for tooth extraction . MATERIAL S AND METHODS This paper presents the 5-year results of the original 12 centers that participated with 143 consecutively included patients . A total of 264 implants  were placed either immediately after tooth extraction or after a short soft-tissue healing time ( 3 - 5 weeks ) . The patients were divided into five subgroups , depending on the type of insertion method used . RESULTS The outcome demonstrated that the cumulative implant survival rate after 5 years of loading has not changed and remains 92.4 % in the maxilla and 94.7 % in the m and ible . No difference in failure rates can be seen between the groups when relating the failures to insertion method . CONCLUSION This prospect i ve study demonstrated that placing Brånemark implants into fresh extraction sites can be successful over a period of 5 years of loading . One of the outcomes of the study shows that there is a clinical correlation between implant failure and periodontitis as a reason for tooth extraction , even if it is difficult to give it a casual association . It can be hypothesized that periodontitis affected tissues might have a negative local influence because of the presence of infrabony defects that could possibly increase the gap between bone and implant or jeopardize achievement of primary stability OBJECTIVE To evaluate marginal bone loss over 3 years around immediate microthreaded implants placed in the maxillary anterior/esthetic zone and immediately restored with single crowns . MATERIAL AND METHODS Seventy-one implants  ( with microthreads up to the platform -- rough surface body and neck , internal connection and platform switching ) were placed in fresh extraction sockets in the maxillary arches of 30 men and 23 women ( mean age 37.85 ± 7.09 years , range 27 - 60 ) . All subjects had at least 3 mm of soft tissue to allow the establishment of adequate biologic width and to reduce bone resorption . Each patient received a provisional restoration immediately after implant placement with slight occlusal contact . Mesial and distal bone height was evaluated using digital radiography on the day following implant placement ( baseline ) and after 1 , 2 , and 3 years . Primary stability was measured with resonance frequency analysis . RESULTS No implants failed , result ing in a cumulative survival rate of 100 % after 3 years . Marginal bone loss from implant collar to bone crest measured at baseline ( peri-implant bone defect at the fresh extraction socket ) and after 3 years was 0.86 mm ± 0.29 mm . Mesial and distal site crestal bone loss ranged from 3.42 mm ± 1.2 mm at baseline to 3.51 mm ± 1.5 mm after 3 years ( P = 0.063 ) and from 3.38 mm ± 0.9 mm at baseline to 3.49 mm ± 0.9 mm after 3 years , respectively ( P = 0.086 ) . CONCLUSIONS This prospect i ve study found minimal marginal bone loss and a 100 % implant survival rate over the 3-year follow-up for microthreaded immediate implants subjected to immediate non-occlusal loading BACKGROUND Animal and human research es have shown that immediate implant placement into extraction sockets failed to prevent socket dimensional changes following tooth extraction . It has been suggested that a minimal width of 1 - 2 mm of buccal bone is necessary to maintain a stable vertical dimension of the alveolar crest . AIM To determine the dimensions of the bony wall at extraction sites in the esthetic zone ( anterior teeth and premolars in the maxilla ) and relate it to immediate implant placement . METHODS As part of an ongoing prospect i ve r and omized-controlled multicenter clinical study on immediate implant placement , the width of the buccal and palatal bony walls was recorded at 93 extraction sites . RESULTS The mean width of the buccal and palatal bony walls was 1 and 1.2 mm , respectively ( P<0.05 ) . For the anterior sites ( canine to canine ) , the mean width of the buccal bony wall was 0.8 mm . For the posterior ( premolar ) sites , it was 1.1 mm ( P<0.05 ) . In the anterior sites , 87 % of the buccal bony walls had a width < or = 1 mm and 3 % of the walls were 2 mm wide . In the posterior sites , the corresponding values were 59 % and 9 % , respectively . CONCLUSIONS If the criterion of a minimal buccal bone width of 2 mm to maintain a stable buccal bony wall is valid , only a limited number of sites in the anterior maxilla display such a clinical situation . The data suggested that in the majority of extraction sites in the anterior maxilla , thin ( < or = 1 mm ) buccal walls were present . This , in turn , means that in most clinical situations encountered , augmentation procedures are needed to achieve adequate bony contours around the implant PURPOSE The aim of this 1-year prospect i ve study was to evaluate , in patients with severe periodontitis , the clinical performance of implants placed immediately after extraction of remaining teeth or in healed sockets and immediately loaded for prosthetic oral rehabilitation , and to compare the clinical outcomes for implants placed in fresh extraction sockets versus healed sites . MATERIAL S AND METHODS All patients in this study had received periodontal treatment ; however , the teeth were eventually deemed hopeless . The remaining teeth were extracted , the periodontally compromised sites were debrided , implants were inserted guided by a surgical template , and a provisional restoration was delivered immediately . The opposing arch was restored with a complete denture . Definitive prostheses were inserted after 6 months . Initial implant and prosthesis stability and the inflammatory response were evaluated . Clinical and radiographic analyses were performed . RESULTS A total of 84 rough-surfaced implants were placed ( 50 in the maxilla and 34 in the m and ible ) . Of these , 32 were placed in fresh extraction sockets . Four implants in three patients failed within the first 6 months , result ing in an implant survival rate of 95.2 % . All of the failed implants had been placed in fresh maxillary extraction sockets . The survival rates were 92 % ( 46/50 ) in the maxilla and 100 % ( 34/34 ) in the m and ible . Prosthetic success was 100 % . The mean bone level change ( ± SE ) between baseline and 12 months was -1.12 ± 0.18 mm . There were no statistically significant differences in insertion torque and alveolar bone loss between post extraction sites and healed sites . CONCLUSIONS The implant failure rate was higher in maxillary post extraction sites . This indicates a heightened risk of failure for immediate implants placed in periodontally compromised maxillae . Nevertheless , a satisfactory prosthetic success was achieved after 1 year PURPOSE The primary goal of this study was to compare implant survival 12 months after immediate loading of  single implants placed in healed ridges versus extraction sockets . Secondary outcomes were to compare marginal bone adaptation and soft tissue changes over time . MATERIAL S AND METHODS A prospect i ve multicenter clinical investigation was initiated to assess clinical performance of  immediately loaded implants in the maxilla .  Implant survival was ascertained at the time of impression making ( 8 to 10 weeks ) and after 1 year by clinical stability . Radiographic marginal bone levels , soft tissue levels , and plaque and bleeding scores were compared with baseline values ( implant placement and provisionalization ) . RESULTS One hundred thirty-nine patients received 157 implants in the maxilla .  Single implants with provisional crowns were placed in extraction sockets of 55 patients ( 58 implants ) and in healed ridges of 60 patients ( 65 implants ) . In addition , 19 patients ( 23 implants ) required bone grafting prior to implant placement , and 11 implants in 10 patients among all groups were not immediately loaded because of insufficient initial stability after surgery . Three implants ( 5.2 % ) failed in extraction sites and one implant ( 1.5 % ) failed in a healed ridge . The mean change in marginal bone level 1 year after implant placement was 1.30 mm ( SD 2.52 ) ( gain ) in extraction sockets and -0.40 mm ( SD 1.43 ) ( loss ) in healed ridges . The mucosal zenith was stable or moved incisally following definitive crown placement in 83.7 % of immediate implants and 87.0 % of implants placed in healed ridges . Plaque and inflammation scores were low and did not differ between groups . CONCLUSIONS The responses of local bone and soft tissues at immediately loaded implants placed in extraction sockets or healed ridges were similar . Furthermore , these 1-year results suggest that clinical management of esthetically critical soft tissue may be predictably achieved in both indications PURPOSE This 5-year prospect i ve multicenter study compared implant survival and success , peri-implant health and soft tissue responses , crestal bone level stability , and complication rates following immediate loading of single OsseoSpeed implants placed in anterior maxillary healed ridges or extraction sockets . MATERIAL S AND METHODS Individuals requiring anterior tooth replacement with single implants  were treated and immediately provisionalized . Definitive all-ceramic crowns were placed at 12 weeks . Implant survival , bone levels , soft tissue levels , and peri-implant health were monitored for 5 years . RESULTS One hundred thirteen patients received implants in fresh sockets ( 55 ) and healed ridges ( 58 ) . After 5 years , 45 and 49 patients remained for evaluation , respectively . During the first year , three implants  failed in the extraction socket group ( 94.6 % survival ) and one implant failed in the healed ridge group ( 98.3 % survival ) ; this difference was not significant . No further implant failures were recorded . After 5 years , the interproximal crestal bone levels were located a mean of 0.43 ± 0.63 mm and 0.38 ± 0.62 mm from the reference points of implants in sockets and healed ridges ( not a significant difference ) . In both groups , papillae increased over time and peri-implant mucosal zenith positions were stable from the time of definitive crown placement in sockets and healed ridges . Compared to flap surgery for implants in healed ridges , flapless surgery result ed in increased peri-implant mucosal tissue dimension ( average , 0.78 ± 1.34 mm vs 0.19 ± 0.79 mm ) . CONCLUSION After 5 years , the bone and soft tissue parameters that characterize implant success and contribute to dental implant esthetics were similar following the immediate provisionalization of implants in sockets and healed ridges . The overall tissue responses and reported implant survival support the immediate provisionalization of dental implants in situations involving healed ridges and , under ideal circumstances , extraction sockets Purpose To evaluate the survival , success , and complication rates of tapered double-lead threads single implants  , placed in fresh extraction sockets and healed sites of the posterior jaws . Methods The enrolled patients were r and omly divided into 2 groups : in the test group ( TG ) , all implants were inserted at the time of tooth extraction ; in the control group ( CG ) , all implants were placed 3 months after extraction . The implants were followed for a period of 1 to 3 years after loading . The main outcomes were implant survival , complications , and implant-crown success . Results Ninety-two patients had 97 installed implants ( 49 in the TG , 48 in the CG ) . Only two implants failed , in the TG ; the survival rates were therefore 95.9 % ( 47/49 ) and 100 % ( 48/48 ) for TG and CG , respectively . In the surviving implants , no complications were reported , for an implant-crown success of 100 % . Conclusions Although a significant difference was found in the levels of primary stability between TG and CG , single implants placed in fresh extraction sockets and healed sites of the posterior jaws had similar survival and complication rates . Crestal bone levels and peri-implant bone resorption showed similar values . A longer follow-up period is however required , to confirm these positive outcomes AIM The purpose of this prospect i ve multicenter clinical study was to compare 3 years implant survival , bone and soft tissue changes following immediate loading using single Osseospeed ( ™ ) implants ( Astra Tech AB , Mölndal , Sweden ) installed in healed ridges or extraction sockets . MATERIAL AND METHODS Implants were provisionally restored the day of surgery using cemented acrylic crowns out of full occlusion . The provisional crowns were replaced after 12 weeks by full-ceramic crowns . Implant survival , bone levels , soft tissue levels and peri-implant health were monitored up to 3 years . RESULTS 55 patients ( 22 men , 33 women ; mean age 45 ) had the implant installed in extraction sockets and 58 patients ( 25 men , 33 women ; mean age 42 ) received conventional implant treatment in healed ridges . Three  implants failed in the extraction group and one implant failed in the healed group , all failures occurred before the final crown placement . No further losses occurred during 3 years , giving a statistically comparable survival rate of 94.6 % and 98.3 % , respectively . The total bone loss after 3 years , compared to implant placement was 0.4 mm ( SD 1.5 ) in healed sites , whilst the immediate sites showed a bone gain of 1.6 mm ( SD 2.4 ) due to bone fill in the alveolus . Papillae retracted with 0.3 and 0.0 mm in the period of provisionalization , but grew back after final crown was placed with 0.3 and 0.5 mm in extraction and healed sites respectively after 3 years . Plaque and inflammation scores were very low throughout the study time , irrespective of treatment modality . CONCLUSIONS Immediate implants restored at the day of surgery show comparable risk for implant failure , bone loss and midfacial soft tissue recession compared to conventionally installed implants . The 3-years results suggest both hard and soft tissue stability BACKGROUND Early implantation may preserve the alveolar anatomy , and the placement of a fixture in a fresh extraction socket helps to maintain the bony crest . Although a number of clinical studies exist , no histological reports show the outcome of implantation in fresh extraction sockets without the use of membranes in humans compared to implants placed in mature bone . METHODS Forty-eight healthy patients , receiving at least 4 fixtures in each of 2 symmetrical quadrants , underwent placement of 1 experimental fixture placed in a fresh extraction socket ( TI ) and 1 contralateral fixture in mature bone ( CI ) . TI were placed after atraumatical tooth extraction , with a surgical site at the apex of the socket and a tight contact between the fixture and the socket 's walls , but without the use of filling material s or membranes . The flap was coronally repositioned to obtain primary wound closure . Immediately after surgical intervention , a st and ardized periapical radiograph was taken . Second-stage surgery was done after 6 months . Six months after the second surgery , a second st and ardized periapical radiograph was taken and clinical parameters ( bleeding and plaque index ) recorded . Marginal bone loss ( MBL ) from the time of implant placement to the time of fixture removal was calculated by comparing periapical radiographs . TI and CI were then removed by a hollow drill to obtain histological specimens . Non-demineralized sections were stained by acid fuchsin and toluidine blue , and by von Kossa to evaluate the degree of bone mineralization . The percentage of direct implant-bone contact ( DBC ) was calculated by a computerized microscopic digitizer . RESULTS No significant differences in the clinical and radiographic parameters were observed between the 2 experimental categories . There was no statistically significant difference between TI and CI for DBC either in the maxilla or in the m and ible . No connective or fibrous tissues were present around TI or CI . Bone resorption was not present in any of the histological sections . CONCLUSIONS The present study shows that when a screw-type dental implant is placed without the use of barrier membranes or other regenerative material s into a fresh extraction socket with a bone-to-implant gap of 2 mm or less , the clinical outcome and degree of osteointegration does not differ from implants placed in healed , mature bone Twenty-one  c.p . titanium screw-shaped implants were immediately installed after extraction and thorough curettage of the alveoli in 15 patients .  Granules of deproteinized bovine bone of 0.25 - 1.0 mm diameter were used to fill the remaining defect when the distance of the defect wall to the implant surface was > 3 mm . Dimensional measurements of the defect height and width were made with a pocket probe . Fourteen sites in the upper jaw and 7 sites in the lower jaw were thus treated . The mean defect depth varied between 7 mm vestibularly and 10 mm mesially . The mucoperiosteal flaps were hermetically closed . At re-entry , the particles were packed and firmly attached but still distinguishable from the surrounding bone . Of the 21 sites treated , 5 sites had an exposure of the implant cover screw during the healing period . An exposure of the granular material occurred in 4 sites , but loss of granules in only 3 . Even in these sites no signs of infection or inflammation of the soft tissues were observed . At re-entry after 6 months , 10 sites were completely and 9 partially filled . For the partial fills , the mean remaining defect height was 1.6 mm ( range : 0.6 - 3.0 mm ) . Two sites showed an increased defect of respectively 2.4 and 4.8 mm . No fixtures were lost . The present results indicate that deproteinized bovine bone is a safe filling material to fill remaining defects around implants installed in fresh extraction sockets PURPOSE The purpose of this prospect i ve study was to evaluate the clinical outcome of implants immediately placed into fresh extraction sockets of teeth affected by chronic periapical pathologic findings , using plasma rich in growth factors ( PRGFs ) as an adjunct during the surgical procedure . MATERIAL S AND METHODS A total of 30 partially edentulous patients with teeth requiring extraction and chronic periapical lesions were included in the present study . A total of 61 transmucosal implants were installed immediately after extraction and careful debridement combined with PRGF placement into the socket . Before insertion , the implant surface was bioactivated by humidification with liquid PRGFs . The prosthetic phase occurred 3 to 4 months after surgery . The implant success and survival and radiographic bone loss were evaluated after 1 year of function . Patient satisfaction for mastication function , phonetics , and esthetics was assessed using a question naire . RESULTS Of the 61 implants , 1 had failed 2 months after insertion because of infection . No additional complications were recorded . The overall implant success and survival rate was 98.4 % at 1 year of function . The mean follow-up was 18.5 months ( range 10 to 21 ) . All prostheses were successful . The peri-implant bone loss after 1 year averaged 0.41 + /- 0.22 mm . All patients reported full satisfaction for mastication function , phonetics , and esthetics . CONCLUSIONS The use of PRGFs combined with an immediate implant placement procedure can be considered a safe , effective , and predictable treatment option for the rehabilitation of fresh post extraction infected sockets The aim of this study was to evaluate and compare the dimensional changes in maxillary extraction sockets that have healed spontaneously and those treated with free gingival grafts .  Ten subjects with at least two maxillary anterior teeth scheduled for extraction were selected for this study . Two maxillary teeth were allocated r and omly to either the test group or the control group . In the test group , the extraction socket was covered with a free gingival graft harvested from the palate , while in the control group the sockets healed spontaneously . Cone beam computed tomography ( CBCT ) scans were taken on the day of extraction and at 3 months postoperative . Soft tissue healing of the extraction sockets was assessed visually by clinical inspection . Hard tissue measurements were obtained from the CBCT scans . After 3 months of healing , the control sockets had lost height in the buccal and lingual crestal bones ( -1.03 and -0.56 mm , respectively ) ; however , the height in the buccal and lingual crestal bones was preserved at the test sites ( + 0.06 and + 0.25 mm , respectively ) . This difference between the two groups was statistically significant ( P<0.05 ) . In contrast , both the control and test groups lost width in the buccal and lingual crestal bones ; the difference between the control and test groups was not statistically significant ( P>0.05 ) . The authors propose that covering the orifice of the extraction socket with a free gingival graft can result in preservation of the alveolar bone height PURPOSE The aim of this study was to report a clinical comparative assessment of crestal bone level change around single implants in fresh extraction sockets in the esthetic zone of the maxilla either immediately loaded or loaded after a delay . MATERIAL S AND METHODS Forty patients were included in a prospect i ve , r and omized study . All patients required 1 tooth extraction ( ie , 1 tooth with a hopeless prognosis ) and were r and omized into either the test group or the control group . Implants were positioned immediately after tooth extraction and were loaded immediately in the test group ( 20 implants ) and after 3 months in the control group ( 20 implants ) . The implant site was prepared , with at least 4 mm of sound apical bone below the implant apex , and the coronal margin of the implant was placed at the buccal level of the bone crest . All implants were 13 mm long ; 30 implants had a diameter of 5 mm , and 10 had a diameter of 3.75 mm . Radiographic examinations were made at baseline , at 6 months , and at 24 months . To compare the mean values between test and control group , a paired t test was performed ( considered statistically significant at P < .05 ) . RESULTS After a 24-month follow-up period , a cumulative survival rate of 100 % was reported for all implants . The control group result ed in a mean mesial bone loss of 1.16 + /- 0.32 mm and a mean distal bone loss of 1.17 + /- 0.41 ( mean bone loss , 1.16 + /- 0.51 mm ) . The test group result ed in a mesial bone loss of 0.93 + /- 0.51 mm and a distal bone loss of 1.1 + /- 0.27 mm ( mean bone loss , 1.02 + /- 0.53 mm ) . No statistically significant difference between control and test groups ( P > .05 ) was found . CONCLUSION The success rate and radiographic results of immediate restorations of dental implants placed in fresh extraction sockets were comparable to those obtained in delayed loading group OBJECTIVES To evaluate immediate placement and immediate restoration of a novel implant with a 12 ° -angled prosthodontic platform , in fresh extraction sockets of the aesthetic zone of the maxilla . MATERIAL S AND METHODS Tapered , roughened surface implants of 4 mm ( n=15 ) or 5 mm ( n=13 ) diameter were placed in 27 participants ( mean age : 47.1 years ; range : 21 - 71 years ) requiring an immediate replacement of single anterior maxillary teeth .  Provisional screw-retained all-ceramic crowns were placed within 4 h following optical impressions . At 8 weeks ( baseline ) , definitive screw-retained all-ceramic crowns were placed in occlusion . RESULTS Twenty-six of the 28 implants met the inclusion criteria at surgery . Marginal bone levels revealed bone gain between surgery and baseline , and between baseline and 1 year of 0.2 mm ( SD 0.75 ) and 0.78 mm ( SD 2.45 ) . Mean mid-buccal mucosal margins showed gains of 0.2 mm ( SD 0.44 ) . Prosthodontic maintenance and the aesthetics of the screw-retained implant crowns were facilitated by the external hex 12 ° -angled prosthodontic platform on the novel implant design , re-orientating the access cavity to the palatal or occlusal surfaces . All-ceramic implant crowns showed a high success rate with low maintenance issues over 1 year . CONCLUSION Tapered , roughened-surfaced implants with a novel 12 ° -angled prosthodontic platform immediately placed in fresh extraction sockets , immediately restored with provisional crowns and subsequent definitive crowns at 8 weeks were successful for 1 year PURPOSE The purpose of this article is to evaluate the soft- and hard-tissue response to immediately placed implants . In addition , assessment was conducted of the soft tissue response to a transmucosal abutment which was narrower than the implant platform . MATERIAL S AND METHODS This study was conducted to evaluate 10 consecutively placed immediately loaded implants placed in extraction sockets in maxillae without compromised bone tissue . The infection control phase of periodontal therapy was completed in the areas of hopeless teeth prior to extraction . Implants with a 6-mm-platform diameter were placed immediately into the fresh extraction sockets . A provisional 4-mm-diameter transmucosal abutment was subsequently connected , and a provisional crown was adapted and adjusted for nonfunctional immediate positioning . Three months following implant placement , definitive prosthetic rehabilitation was performed . At the time of prosthesis insertion ( baseline ) and every 6 months thereafter , radiographic assessment s , pocket probing depth ( PPD ) , recession , and papilla height were measured . An image analysis software application was used to compare the radiographic bone crestal bone heights at the mesial and distal aspects of the implants . RESULTS Nine patients with 10 sites were treated . Mean follow-up time was 22 months ( range , 18 to 36 months ) . All 10 implants were found to be clinical ly osseointegrated . Software analysis of radiographic films showed a bone resorption of 0.78 + /- 0.36 mm . The mean values were significantly lower ( P < or = .005 ) than a mean reference value of 1.7 mm . PPD did not exceed 3 mm in any site ( average , 2.8 mm ) . Rather than recession , there was a mean gain in the buccal margin of 0.2 mm and a mean gain in papilla height of 0.25 mm . CONCLUSION This proof-of-concept study suggests that immediate loading with platform switching can provide peri-implant hard tissue stability with soft tissue and papilla preservation . ( Case Series PURPOSE The aim of this prospect i ve clinical study was to evaluate the survival rates at 12 months of a new implant design placed in the anterior and premolar areas of the maxilla and immediately restored with single crowns . Crestal bone loss was also assessed . MATERIAL S AND METHODS Patients seeking replacement of at least one failing maxillary tooth were recruited to participate in the study . Exclusion criteria included compromised general health conditions , severe maxillom and ibular skeletal discrepancies , severe parafunctional habits , drug or alcohol abuse , poor oral hygiene , and a need for bone augmentation .  Implants incorporating the platform-switching concept were placed into fresh extraction sockets in the maxilla , with each patient receiving a provisional restoration immediately after implant placement . After 15 days , definitive restorations were inserted . Mesial and distal bone levels were evaluated with digital radiography on the day after implant placement , 15 days later , and 1 , 2 , 3 , 6 , 8 , and 12 months later . Primary stability was measured with resonance frequency analysis ( RFA ) . Analysis of variance for repeated measures and a binary logistic regression model were used to assess the data . RESULTS Sixty-one implants were placed into fresh extraction sites in 25 men and 25 women ranging in age from 29 to 51 years ( mean , 39.64 + /- 6.06 years ) . One of the implants failed , and one was lost to follow-up . The mean bone loss measured on the mesial was 0.08 mm ( SD 0.53 mm ) . Mean distal bone loss was 0.09 mm ( SD 0.65 mm ) . Over the course of 12 months , the mean RFA value between baseline and 12 months was 71.1 + /- 6.2 . CONCLUSIONS The implants remained stable over the course of 12 months and had an overall survival rate of 96.7 % . Minimal crestal bone loss was recorded around the surviving implants PURPOSE The purpose of the study was to compare the clinical and aesthetic outcome of single post-extractive implants versus implants placed in a preserved socket after 4 months of healing in the anterior maxilla . All of the implants were immediately non-occlusally loaded . MATERIAL S AND METHODS A total of 50 patients were treated in the two groups of study . The Delayed Group had a maxillary tooth ( premolar , canine , lateral or central incisor ) removed , with immediate socket grafting , followed by implant placement and provisionalisation 4 months later . The Immediate Group had immediate implant placement and provisionalisation . Outcome measures were implant failures , biological and biomechanical complications , peri-implant radiographic bone level changes , and gingival aesthetics . RESULTS At the 12-month follow-up , two implants failed in the Immediate Group ( 8 % ) versus one in the Delayed Group ( 4 % ) , with a comparable rate of implant failure ( P = 0.55 ) . No complications occurred for either group . The 12-month peri-implant bone resorption was similar in both groups ( P = 0.23 ) : 0.71 mm ( 95 % CI 0.45 , 0.97 ) in the Immediate Group versus 0.60 mm ( 95 % CI 0.38 , 0.82 ) in the Delayed Group . The mean difference in bone resorption was 0.13 mm ( 95 % CI -0.21 , 0.47 ) . An ideal gingival marginal level was reached most frequently in the Delayed Group ( 83.3 % versus 52.1 % , P = 0.04 ) . Rates of full closure of the papilla were similar between the two groups ( 82.6 % for the Immediate Group versus 62.5 % for the Delayed Group , P = 0.12 ) . CONCLUSIONS Given the limitation that this was not a r and omised controlled trial , there were no differences in complications or crestal bone response at immediate post-extractive implants when compared to delayed implants . A delayed protocol might be considered in the aesthetic zone due to the gingival recession that occurs after post-extractive implant placement PURPOSE To compare the effectiveness of immediate post-extractive single implants  with delayed implants placed in preserved sockets after 4 months of healing . Implants that achieved an insertion torque of at least 35 Ncm were immediately non-occlusally loaded . MATERIAL S AND METHODS Just after tooth extraction and in the presence of a loss of the buccal plate bone less than 4 mm , compared to the palatal wall , 106 patients requiring a single immediate postextractive implant in the maxilla from second premolar to second premolar were r and omly allocated to immediate implant placement ( immediate group ; 54 patients ) or to socket preservation using anorganic bovine bone covered by a resorbable collagen barrier  ( delayed group ; 52 patients ) according to a parallel group design at three different centres . Bone-to-implant gaps were to be filled with anorganic bovine bone , however this was not done in 17 patients ( corresponding to 40 % of those who should have been grafted ) . Four months after socket preservation , delayed implants were placed . Implants placed with an insertion torque > 35 Ncm were immediately loaded with non-occluding provisional single crowns , replaced , after 4 months , by definitive crowns . Outcome measures were implant failures , complications , aesthetics assessed using the pink esthetic score ( PES ) , and patient satisfaction , recorded by blinded assessors . All patients were followed up to 4 months after loading . RESULTS Nineteen ( 35 % ) implants were not immediately loaded in the immediate group versus 39 ( 75 % ) implants in the delayed placement group because an insertion torque > 35 Ncm could not be obtained . No patient dropped out . Two implants failed in the immediate group ( 4 % ) versus none in the delayed group . More minor complications occurred in the immediate group ( 8) than the in the delayed group ( 1 ) and this was statistically significant ( P = 0.032 ) . At delivery of definitive crowns , 4 months after loading , aesthetics were scored as 12.8 and 12.6 in the immediate and delayed groups , respectively . There was no statistically significant difference ( P = 0.5 ) . Patients of both groups were equally satisfied . CONCLUSIONS There were more complications at immediate post-extractive implants when compared to delayed implants . The aesthetic outcome appears to be similar for both groups and it seems more difficult to obtain a high insertion torque in sockets preserved with anorganic bovine bone
Conclusion It can be concluded that bone remodeling occurs after tooth extraction and immediate implant installation
Purpose The objective of this systematic review was to assess the three-dimensional changes in bone tissue after immediate installation of a single implant in a fresh extraction socket in the anterior maxilla .