Immediate implant placement into extraction sites with periapical lesions in the esthetic zone: a case report

Jae-Young Yi; Jee-Hwan Kim; Dong-Hoo Han

doi:10.4047/jkap.2012.50.3.191

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Yi, Kim, and Han: Immediate implant placement into extraction sites with periapical lesions in the esthetic zone: a case report

Case Report

The Journal of Korean Academy of Prosthodontics

The Journal of Korean Academy of Prosthodontics 2012; 50(3): 191-197.

Published online: 31 July 2012

DOI: https://doi.org/10.4047/jkap.2012.50.3.191

Immediate implant placement into extraction sites with periapical lesions in the esthetic zone: a case report

Jae-Young Yi, DDS, Jee-Hwan Kim, DDS, MSD, PhD, Dong-Hoo Han, DDS, MSD, PhD

Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul, Korea.

Corresponding Author: Dong-Hoo Han. Department of Prodthodontics, College of Dentistry, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea. +82 2 2228 3163: DONGHOOHAN@yuhs.ac

Received 6 July 2012 Revised 16 July 2012 Accepted 23 July 2012

Abstract

Esthetics is important in restoring maxillary anterior area. Alveolar bone resorption and loss of interdental papilla may be minimized by immediate implantation. Previous studies showed successful results with the immediate implantation in healthy extraction socket, while many of these studies objected the immediate implantation into extraction sites with periapical lesions. Recent studies, however, reported successful results of the immediate implantation into extraction sites with periapical lesions with careful debridement of extraction sockets and general medication of antibiotics prior to implantation. A 73-year-old female visited the department of Prosthodontics in ○○ University Dental Hospital with the chief complaint of fallen post-core and crown on left maxillary incisor. Although the incisor was with vertical root fracture and periapical lesion, the immediate implantation following the extraction of tooth was planned. Thorough socket debridement, irrigation with chlorhexidine, and tetracycline soaking were followed by immediate implantation. The general medication of antibiotics (Moxicle Tab.®, 375 mg) was prescribed before and after the surgery. Immediate provisional restoration was delivered two days after the surgery, and the definitive metal-ceramic restoration was placed about six months later after reproducing the emergence profile from the provisional restoration. This case presents satisfying result esthetically and functionally upto two years after the placement of prosthesis with the harmonious gingival line and no loss of marginal bone.

Keywords: Immediate implantation, Periapical lesion, Maxillary anterior tooth

Figures and Tables

Fig. 1

Intraoral photos and periapical radiograph at first visit. A: Maxillary left central incisor from labial view, B: Maxillary left central incisor from incisal view, C: Periapical radiograph of maxillary left central incisor with periapical radiolucent area.

Fig. 2

Post-extraction procedures. A: Assessment of extraction socket, B: Measurement of distance between marginal gingival and marginal bone with probe, C: Chlorhexidine irrigation, D: Tetracycline soaking.

Fig. 3

Surgical procedures. A: Drilling towards apical and palatal directions , B: Tapping, C: Implant installation, D: 1 - 1.5 mm of gap exists between implant fixture and labial bone plate.

Fig. 4

A: Impression taking for immediate provisional restoration, B: Initial placement of immediate provisional restoration.

Fig. 5

Impression taking for definitive restoration. A: Registration of emergence profile of provisional restoration using putty index, B: Reproduction of emergence profile on impression coping, C: Connection of customized impression coping.

Fig. 6

Definitive restoration. A: Customized abutment on definitive model, B: Metal-ceramic restoration on definitive model, C: Initial placement of metal-ceramic restoration.

Fig. 7

A: Intraoral photo and periapical radiograph 6 months after initial placement, B: Intraoral photo and periapical radiograph 2 years after initial placement.

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