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Year : 2013  |  Volume : 5  |  Issue : 6  |  Page : 147-149  

Immediate placement of dental implants in the mandible

1 Department of Prosthodontia, Farooqia Dental College and Hospital, Mysore, Karnataka, India
2 Department of Oral Pathology, Farooqia Dental College and Hospital, Mysore, Karnataka, India

Date of Submission16-May-2013
Date of Decision24-May-2013
Date of Acceptance24-May-2013
Date of Web Publication1-Jul-2013

Correspondence Address:
Gurkar Haraswarupa Puttaraju
Department of Prosthodontia, Farooqia Dental College and Hospital, Mysore, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0975-7406.114311

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This case describes extraction of teeth in the mandibular arch, i.e., 41 42 43 44 45 51 52 53 54 55 56 57 58 (grade two mobility), followed by immediate placement of four dental implants (3i biomet), two in the 45 55 region and two dental implants in 12 21 region. A prefabricated provisional mandibular denture was immediately placed. The purpose of immediate placement was to aid the patient resume his professional duties the next day itself along with esthetic and functional comfort, psychological well-being and most importantly preserving the remaining tissue in a healthy condition.

Keywords: Dental implants, immediate placement, osseointegration, provisional denture

How to cite this article:
Puttaraju GH, Visveswariah PM. Immediate placement of dental implants in the mandible. J Pharm Bioall Sci 2013;5, Suppl S2:147-9

How to cite this URL:
Puttaraju GH, Visveswariah PM. Immediate placement of dental implants in the mandible. J Pharm Bioall Sci [serial online] 2013 [cited 2022 Aug 8];5, Suppl S2:147-9. Available from:

Predictable and definitive dental implant prosthodontics despite high rate of success has yet to achieve wide public acceptance and utilization. [1]

Placement of endosseous implants has made it possible to perform restorations in patients who are fully or partially edentulous. [2] Original protocols required the placement of implants into healed edentulous ridges. In 1989, Lazzara placed implants at the time of tooth extraction.

The advantages of immediate implant placement are:

  1. Treatment time is reduced
  2. Amount of surgery is reduced
  3. Width and height of the alveolar bone are preserved
  4. Ideal implant location can be achieved provided that the extracted tooth has a desirable
  5. The implant will prevent postsurgical bone resorption seen following tooth extraction as a normal part of the socket healing alignment and there is maximum soft-tissue support.
As an adjunct to these advantages, several others accrue, which include less surgical morbidity, preservation of gingival tissues, reduction of alveolar bone resorption, preservation of papilla in the esthetic zone, a reduction in treatment expense as additional regenerative techniques (bone grafts and membrane use) are not applied and better patient acceptance of the treatment plan. [2],[3],[4]

The stability of implants can be determined using a resonance frequency analysis. This method requires the placement of an electronic transducer on the implant head or prosthetic abutment with a retaining screw, and the passing of a low-voltage current, which is undetectable to patient, through the transducer. Resistance to the vibration of the transducer in the surrounding bone is digitally registered. The original resonance frequency measurements were recorded in hertz, but were later converted to implant stability quotient units.

Teeth requiring root amputation, hemisection, or advanced periodontal procedures may have a questionable prognosis and patients should be given reasonable options. Many clinicians postpone treatment of sites exhibiting infection. Novaes et al. and Villa and Rangert recently reported on a case series of patients where implants were installed immediately after extraction, and where the extracted teeth exhibited signs of periodontal or endodontic infections. At 2 years post-treatment, the cumulative survival rate was 100%. This study indicated no adverse consequences for an implanted site after extracting an infected tooth. [5]

   Case Report Top

A 50-year-old male patient presented with a history of moderate periodontitis with Grade 2 mobility of most of the mandibular [Figure 1] teeth and his profession dictated for an immediate solution. Clinical and radiological evaluation revealed adequate alveolar bone support. Atraumatic extraction of 41 42 43 44 45 51 52 53 54 55 56 57 58 was carried out under local anesthesia [Figure 2] using lignocaine with adrenalin. Atraumatic extraction using periotomes without excessive enlargement of the socket was done in order to preserve the alveolar bone which is very important to the success of immediate implant placement. The implant size is determined by the help of the root length and diameter also with conventional methods [Figure 3] and [Figure 4]. The sockets were debrided and 3i Biomet implants 4 mm × 11.5 mm were placed in the extracted sockets of 45 55 12 22 [Figure 5] and [Figure 6]. Stability was checked by osstell [Figure 5]. Patient was administered appropriate antibiotic and analgesic. A pre-fabricated mandibular provisional denture with a soft reline was placed [Figure 7].
Figure 1: Pre-operative view showing the mandibular teeth

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Figure 2: Extracted teeth (above)

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Figure 3: Measuring the root length to synchronize with the implant

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Figure 4: Placement of implants (above)

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Figure 5: Osstell to check the stability of the implant

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Figure 6: Post-operative orthopantamogram with implants

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Figure 7: Insertion of provisional denture

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   Conclusion Top

Success in dental implants is a result of certain level of competence of the dentist along with use of products that ensure predictable functional balance between technology and biology, which predicts a lifelong functional and esthetic solution for the patient. The advent of calcium oxide anodized titanium surface treated implants has shown to accelerate and enhance the osseointegration of the implant in the living bone. [6]

   References Top

1.Wagenberg BD, Ginsburg TR. Immediate implant placement on removal of the natural tooth: Retrospective analysis of 1,081 implants. Compend Contin Educ Dent 2001;22:399-404, 406, 408 passim.  Back to cited text no. 1
2.Froum SJ. Immediate placement of implants into extraction sockets: Rationale, outcomes, technique. Alpha Omegan 2005;98:20-35.  Back to cited text no. 2
3.Cornelini R, Scarano A, Covani U, Petrone G, Piattelli A. Immediate one-stage postextraction implant: A human clinical and histologic case report. Int J Oral Maxillofac Implants 2000;15:432-7.  Back to cited text no. 3
4.Chandra Sekar A, Praveen M. Aarti saxena gautam, immediate implant placement a case report. J Indian Prosthodont Soc 2012;12:120-2.  Back to cited text no. 4
5.Becker W, Goldstein M. Immediate implant placement: Treatment planning and surgical steps for successful outcome. Periodontol 2000 2008;47:79-89.  Back to cited text no. 5
6.Krishna Murthy A. Application and indication specific implant macrodash design concept for rehabilitation of edentoulus jaws. Famdent 2012;13:88-94.  Back to cited text no. 6


  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7]


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