Immediate Dental Implants for Esthetic and Premolar Sites

The editors Douglas Deporter, DDS, PhD, is Professor in the Discipline of Periodontics, Faculty of Dentistry, University of Toronto in Toronto, Ontario, Canada. Mohammad Ketabi, BDS, MDS, is Professor in the Discipline of Periodontics in the Faculty of Dentistry at IAU (Isfahan Branch), Iran & Adjunct Professor in the faculty of Dentistry at the University of Toronto in Toronto, Ontario, Canada.

• List of Contributors ixForeword xviiPreface xviiiAcknowledgments xix1 Introduction, History and General Principles 1Douglas Deporter, Domenico Baldi, and Mohammad KetabiBackground 1The Timing of Implant Placement 1Early Work with Immediate Implant Placement 6Biological Benefits of “Immediacy” 7Indications for Immediate Implant Placement in Anterior and Premolar Sites 8Impact of Socket Configuration on Immediate Implant Placements 14Accepted Ways of Minimizing Peri-Implant Crestal Bone Loss with Immediate Implant Placements 16Conclusions 17References 172 Radiographic and Anatomic Considerations 25Venessa Mendes and Trevor ThangIntroduction 25Imaging Techniques 25Cone Beam Computed Tomography 25Radiographic Evaluation for Immediate Implant Placement 26General Osseous Considerations 26Alveolar Bone Thickness 26Variations in Trabecular Bone Density 26Nasopalatine Canal and Foramen 27Middle Superior Alveolar Canals 29Nasal and Maxillary Sinus Floors 30Mental Foramen 30Anterior Loop of the Inferior Alveolar Nerve 31Mandibular Incisive Canal 31Lingual Foramina 34Tooth-Related Complications 34Mandibular Canine Bifurcations 34Conclusions 35References 363.1 Immediate Implant Placement in the Maxillary Esthetic Zone 39Henny J.A. Meijer, Vincent J.J. Donker, and Gerry M. RaghoebarIntroduction 39Preoperative Screening 40Implant Surgery in General 40Immediate Implant Treatment in Combination with Immediate Provisionalization 40Assessment 40Diagnosis and Planning Procedures 40Surgical Procedures 40Prosthetic Procedures 41Follow-up 41Case Presentation One 41Case Presentation Two 41Case Presentation Three 48Case Presentation Four 51Discussion 53Conclusions 54References 543.2 Immediate Maxillary Premolar Implant Placement 56Mehdi Valizadeh, Antonio Barone, Rossana Izzetti, Chiara Cinquini, and Celine SoonIntroduction 56Sagittal Root Position and Bone Angulation 56Maxillary Sinus Proximity 57Case Selection 61Intact Versus Non-Intact Socket 61Suggested Surgical Protocols 61Extraction 61Attaining Bone Anchorage 61Implant Selection 63Soft Tissue Modification 65Discussion 69References 693.3 Challenges in Placing Multiple Immediate Implants in Anterior Maxilla 72Douglas Deporter, Mohammad Ketabi, Richard Martin, and Ehsan BirangIntroduction 72Case Selection 74Further Sample Cases 76Conclusions 81References 814 Immediate Implant Placement in Mandibular Anterior and Premolar Sites 83Stuart Froum, Deporter Douglas, Dai Lao Rodriguez, Mohammad Ketabi, and Benedetta GrassiIntroduction 83Sample Cases 86Case One 86Sample Case Two 86Conclusions 94References 945.1 Minimally Invasive Guided Bone Regeneration Techniques for Hard and Soft Tissue Augmentation with Simultaneous Immediate Implant Placement 97Mehrdad LotfazarIntroduction 97Tunneling 97Intrasocket Guided Bone Regeneration 98The Ice Cream Cone Technique 105Conclusion 113References 1175.2 Immediate Implants Needing Traditional Guided Bone Regeneration 119Douglas Deporter, Amir Moeintaghavi, and Mohammad KetabiIntroduction 119Sample Cases 119Case One 119Case Two 122Case Three 122Discussion 122References 1285.3 Immediate Implant Placement in Compromised Maxillary Anterior and Bicuspid Sites: Immediate Dentoalveolar Restoration with Osseodensification 129José Carlos Martins da RosaIntroduction 129Immediate Dentoalveolar Restoration Technique 129Case Selection 132Discussion 133Conclusions 139References 1395.4 Aesthetic Reconstruction of Severely Resorbed Alveolar Bone with Immediacy using Tenting Healing Abutments or Tooth Bone “Rings” 141Dong-Seok SohnIntroduction 141Background 141Autogenous Block Bone Grafting 141Intraoral Distraction Osteogenesis 141Sandwich Augmenting with Interpositional Bone Grafting 141Split Bone Block Technique 142Guided Bone Regeneration (GBR) 142Soft Tissue Matrix Expansion Technique Using A Tenting Pole Technique 142The Vertical Tenting Pole Abutment 142Description of the Sohn Bone Builder Tenting Pole Approach 143Using Vertical Tenting Pole Healing Abutments in a Maxillary Anterior Site 143Case One 143Case Two 146Vertical Bone Regeneration Around Immediate Implants Using Demineralized Tooth “Rings” 152Discussion 164Conclusion 164References 1656 Soft Tissue Grafting with Immediate Implant Placement 169Neda Moslemi and Mohammad Reza TalebiIntroduction 169Evolution of Soft Tissue Grafting during Immediate Implant Placement 169To Preserve/Improve Buccal Contour Convexity 170To Prevent Peri-Implant Soft Tissue Dehiscence/Deficiency 171To Preserve/Improve Interproximal Papilla Thickness/Height 171To Minimize the Need for Buccal Flap Advancement 171Should Soft Tissue Grafting be Considered as the Standard of Care in Esthetic Immediate Implant Placement? 172Surgical Techniques for Soft Tissue Grafting 172Scarf-Connective Tissue Graft 172Scarf-Connective Tissue Graft versus Coronally Advanced Flap/Tunnel Technique plus Connective Tissue Graft 172Tunnel Technique plus Connective Tissue Graft 172Coronally Advanced Flap plus Connective Tissue Graft 179When to Select Coronally Advanced Flap plus Connective Tissue Graft or Tunnel Technique plus Connective Tissue Graft? 179Rotated Pedicle Palatal Flap (RPPF) 179Why Perform Soft Tissue Grafting and Immediate Implant Placement in the Same Surgery? 186How Stable Are the Results of Soft Tissue Grafting? 186Conclusion 193References 1937 Anatomically Guided Immediate Implant Placement in Maxillary Anterior and BicuspidSites 197Deporter Douglas, Quang Nguyen, and Mohammad KetabiIntroduction 197The Concept of Anatomically Guided Implant Placement 197Discussion and Conclusions 204References 2108 Guided Surgery for Placing Immediate Implants using Standard Osteotomy Preparation or Osseodensification 213Arndt GuentschIntroduction 213Digital Workflows in Implant Dentistry 213Data Acquisition 214Intraoral Surface Scan (IOS) 215Virtual Treatment Planning 215Data Manipulation 215Registration of Cone Beam Computed Tomography and Intraoral Surface Scan 216Virtual Tooth Extraction 216Wax-up 220Three-Dimensional Implant Positioning 220Guide Design 222Sleeve Selection 222Basic Design Principles 222Workflow for Guide Design 223Guide Production 226Guided Implant Surgery 227Immediate Implant Placement with Customized Provisional or Healing Abutment 229Immediate Implant Placement with Guided Osseodensification 230Conclusions 239References 2399 Optimizing Immediate Loading with Immediate Implants 245Adriano Piattelli, Luca Comuzzi, Alessandro Cipollina, Tea Romasco, Giulia Marchioli, Natalia Di Pietro, and Amirhossein MajidiIntroduction 245History of Immediately Loaded Implants 245Microstructure of Bone under Loading 246Immediate Loading of Immediate Implants 247Biconometric Concept and Navigated Surgery 247Use of Dynamic Navigation for Immediate Functional-Loaded Immediate Implant Placement 254Pre- and Immediate Postoperative Use of a Zinc-L-Carnosine Mouthwash 255Use of Complex Magnetic Fields during Healing of Immediate Functional Loaded Immediate Implant Placements 260Conclusions 261References 26210 Emergence Profile Following Immediate Implant Placement in the Esthetic Zone 265Edwin Ruales-Carrera, Patrícia Pauletto, Lenin Proaño, and José Luis ViteriIntroduction 265Implant Selection and its Relation to the Emergence Profile 265Implant Placement in the Esthetic Zone 266The Emergence Profile Contours 266Timing of Implant Placement and its Relation to Emergence Profile 267Prosthetic Modification of the Emergence Profile 268Transfer of the Emergence Profile 269Restorative Materials and their Relation to the Emergence Profile 269Conclusions 273References 27311 Immediate Implant Placement in Infected Tooth Sockets 275Mahdi Kadkhodazadeh, Anahita Moscowchi, and Reza AmidIntroduction 275Treatment Steps 280Extraction of Infected Teeth 280Complete Debridement of Tooth Extraction Sockets 280Platelet Concentrations in Infected Site Implantation 280Are Systemic Antibiotics Needed? 280Assessment of Treatment Success 284Complications 284Conclusions 284References 28712 Angled Implant Design (Dual Axis Implants) in Immediate Implant Placement in the Anterior Maxilla 289Mehdi Valizadeh, Dale Howes, Petros Yuvanoglu, Costa Nicolopoulos, and Stephen ChuIntroduction 289Anatomy of Teeth, Alveolar Bone, and Sagittal Root Position 289Apical Socket Perforation Rate 290Cement-Retention Versus Screw-Retention and the Issue of Buccally Inclined Implants 291Angle-Correcting Abutments and Angled Screw Channels 291Subcrestal Angle Correction: Development of a Root Form Dual Axis Implant 292Screw Loosening 295Variable Platform Switching 299Macro Hybrid Subcrestal Angle Correction Implant (Body Shift Concept) 299Conclusions 300References 30413 Complications with Immediacy and their Management 309Stuart Froum, Douglas Deporter, Nasrin Esfahanizadeh, Mohammad Ketabi, and Chih Hao ShyuIntroduction 309Potential Complications 310Excessive Bleeding 310Buccal or Lingual Plate Perforations 310Implant Misalignments and Malpositioning 311Damage to Vital Structures 315Esthetic and Soft Tissue Complications 318Post-Treatment Infection 318Conclusions 323References 323Index 327