Journal of Pharmacy And Bioallied Sciences

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

Immediate placement of dental implants in the mandible

Gurkar Haraswarupa Puttaraju1, Paranjyothi Magadi Visveswariah2,  
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

Correspondence Address:
Gurkar Haraswarupa Puttaraju
Department of Prosthodontia, Farooqia Dental College and Hospital, Mysore, Karnataka


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.

How to cite this article:
Puttaraju GH, Visveswariah PM. Immediate placement of dental implants in the mandible.J Pharm Bioall Sci 2013;5:147-149

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 7 ];5:147-149
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Full Text

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:

Treatment time is reducedAmount of surgery is reducedWidth and height of the alveolar bone are preservedIdeal implant location can be achieved provided that the extracted tooth has a desirableThe 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

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}{Figure 2}{Figure 3}{Figure 4}{Figure 5}{Figure 6}{Figure 7}


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]


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