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13
COMMON COMPLICATIONS WITH IMMEDIATE MOLAR IMPLANT PLACEMENT
228
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4. Schropp L, Wenzel A, Kostopoulos L, Karring T. Bone healing
and soft tissue contour changes following single-tooth extraction: A clinical and radiographic 12-month prospective
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success of GBR. Smoking, timing of implant placement, implant
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6. Lazzara RJ. Immediate implant placement into extraction sites:
Surgical and restorative advantages. Int J Periodontics Restorative Dent 1989;9:332–343.
7. Schwartz-Arad D, Chaushu G. e ways and wherefores of immediate placement of implants into fresh extraction sites: A literature review. J Periodontol 1997;68:915–923.
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Maxillofac Implants 2006;21:71–80.
9. Froum S, Casanova L, Byrne S, et al. Risk assessment before extraction for immediate implant placement in the posterior mandible: A computerized tomographic scan study. J Periodontol
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10. Rodriguez-Tizcareño MH, Bravo-Flores C. Anatomically guided
implant site preparation technique at molar sites. Implant Dent
2009;18:393–401.
KEY POINTS
•
The most common error or complication with the use of immediate molar implants is
malpositioning of the implant too far buccally or not placing it centrally in the mesiodistal
dimension. Delaying tooth root removal until after osteotomy creation will allow anatomically guided placement into the IRS.
• The optimal distance between an IMI and its adjacent tooth or teeth is 2 to 4 mm; otherwise, root caries risk can be a complication.
•
Overseating IMIs is a risk for molars with long root trunks or furcal bone loss. Ideally, threaded
implants should be placed subcrestally but only by 1 to 2 mm relative to the lowest bone
crest buccally.
•
Lingual plate perforation can occur with placement of mandibular IMIs, but this can be
avoided by examining pretreatment CBCTs.
•
Sinus violation is always a risk with reduced subantral bone height, intrusion of maxillary
molar roots into the sinus, or where the distances for root apices to sinus floor are < 5 mm.
Inadvertent sinus floor perforation is frequent but generally of no clinical significance.
•
Soft and hard tissue collapse over time, particularly on the buccal aspect, can be minimized
by correct 3D implant positioning and, if necessary, buccal onlay grafting of particulate
xenograft and/or soft tissue grafting should the site have a thin buccal plate (≤ 1.5 mm)
and/or thin gingival biotype.
Conclusion
Placing IMIs is a dicult intervention and does come
with the risk of complications without careful plan
-
ning and execution. e most common errors include
improper 3D positioning, inadequate initial stability, damage of vital anatomical structures, and early
infection.
229
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11. Scarano A. Traditional postextractive implant site preparation
compared with pre-extractive interradicular implant bed preparation in the mandibular molar region, using an ultrasonic device: A randomized pilot study. Int J Oral Maxillofac Implants
2017;32:655–660.
12. Smith RB, Tarnow DP, Sarnachiaro G. Immediate placement of
dental implants in molar extraction sockets: An 11-year retrospective analysis. Compend Contin Educ Dent 2019;40:166–
170.
13. Deporter D, Khoshkhounejad AA, Khoshkhounejad N, Ketabi
M. A new classication of peri implant gaps based on gap location (a case series of 210 immediate implants). Dent Res J (Isfahan) 2021;18:29.
14. Spray JR, Black CG, Morris HF, Ochi S. e inuence of bone
thickness on facial marginal bone response: Stage 1 placement
through stage 2 uncovering. Ann Periodontol 2000;5:119–128.
15. Qahash M, Susin C, Polimeni G, Hall J, Wikesjö UM. Bone healing dynamics at buccal peri-implant sites. Clin Oral Implants
Res 2008;19:166–172.
16. Monje A, Chappuis V, Monje F, et al. e critical peri-implant
buccal bone wall thickness revisited: An experimental study in
the beagle dog. Int J Oral Maxillofac Implants 2019;34:1328–
1336.
17. Hu C, Gong T, Lin W, Yuan Q, Man Y. Immediate implant placement into posterior sockets with or without buccal bone dehiscence defects: A retrospective cohort study. J Dent 2017;65:95–
100.
18. Alexopoulou M, Lambert F, Knafo B, Popelut A, Vandenberghe
B, Finelle G. Immediate implant in the posterior region combined with alveolar ridge preservation and sealing socket abutment: A retrospective 3D radiographic analysis. Clin Implant
Dent Relat Res 2021;23:61–72.
19. Brugnami F, Caiazzo A. Ecacy evaluation of a new buccal bone
plate preservation technique: A pilot study. Int J Periodontics
Restorative Dent 2011;31:67–73.
20. Birang E, Deporter D, Birang R, Mahabadi M, Atenafu E, Ketabi
M. Eectiveness of buccal pouch grafting in minimizing loss of
alveolar dimension: A canine investigation. Dent Res J (Isfahan)
2019;16:338–345.
21. Zamzok J. Nonsurgical soft tissue sculpting. Alpha Omegan
1997;90:65–69.
22. Smith RB, Tarnow DP. Classication of molar extraction sites
for immediate dental implant placement: Technical note. Int J
Oral Maxillofac Implants 2013;28:911–916.
23. Esposito M, Ekestubbe A, Gröndahl K. Radiological evaluation
of marginal bone loss at tooth surfaces facing single Brånemark
implants. Clin Oral Implants Res 1993;4:151–157.
24. Smith RB, R awdin SB, Kagan V. Inuence of implant-tooth proximity on incidence of caries in teeth adjacent to implants in molar sites: A retrospective radiographic analysis of 300 consecutive implants. Compend Contin Educ Dent 2020;41:e1–e5.
25. Fu JH, Yeh CY, Chan HL, Tatarakis N, Leong DJ, Wang HL. Tissue biotype and its relation to the underlying bone morphology.
J Periodontol 2010;81:569–574.
26. Isler SC, Uraz A, Kaymaz O, Cetiner D. An evaluation of the relationship between peri-implant soft tissue biotype and the severity of peri-implantitis: A cross-sectional study. Int J Oral
Maxillofac Implants 2019;34:187–196.
27. Linkevicius T, Apse P, Grybauskas S, Puisys A. e inuence of
soft tissue thickness on crestal bone changes around implants:
A 1-year prospective controlled clinical trial. Int J Oral Maxillofac Implants 2009;24:712–719.
28. Schrott AR, Jimenez M, Hwang JW, Fiorellini J, Weber HP. Fiveyear evaluation of the inuence of keratinized mucosa on
peri-implant soft-tissue health and stability around implants
supporting full-arch mandibular xed prostheses. Clin Oral Implants Res 2009;20:1170–1177.
29. Wennström JL, Derks J. Is there a need for keratinized mucosa
around implants to maintain health and tissue stability? Clin
Oral Implants Res 2012;23(suppl 6):136–146.
30. Matsuda H, Borzabadi-Farahani A, Le BT. ree-dimensional
alveolar bone anatomy of the maxillary rst molars: A conebeam computed tomography study with implications for immediate implant placement. Implant Dent 2016;25:367–372.
31. Ragucci GM, Elnayef B, Criado-Cámara E, Del Amo FS, Hernández-Alfaro F. Immediate implant placement in molar extraction
sockets: A systematic review and meta-analysis. Int J Implant
Dent 2020;6:40.
32. Bruschi GB, Crespi R, Capparè P, Bravi F, Bruschi E, Gherlone E.
Localized management of sinus oor technique for implant
placement in fresh molar sockets. Clin Implant Dent Relat Res
2013;15:243–250.
33. Huwais S, Mazor Z, Ioannou AL, Gluckman H, Neiva R. A multicenter retrospective clinical study with up-to-5-year follow-up
utilizing a method that enhances bone density and allows for
transcrestal sinus augmentation through compaction grafting.
Int J Oral Maxillofac Implants 2018;33:1305–1311.
34. Toer M, Rosen P. Complications with transcrestal sinus oor
elevation: Etiology, prevention, and treatment. In: Froum S
(ed). Dental Implant Complications: Etiology, Prevention, and
Treatment. Hoboken: John Wiley & Sons, 2016:428–455.
35. Reiser GM, Rabinovitz Z, Bruno J, Damoulis PD, Grin TJ.
Evaluation of maxillary sinus membrane response following elevation with the crestal osteotome technique in human cadavers. Int J Oral Maxillofac Implants 2001;16:833–840.
36. Mardinger O, Manor Y, Mijiritsky E, Hirshberg A. Lingual perimandibular vessels associated with life-threatening bleeding:
An anatomic study. Int J Oral Maxillofac Implants 2007;22:127–
131.
37. Huang RY, Cochran DL, Cheng WC, et al. Risk of lingual plate
perforation for virtual immediate implant placement in the posterior mandible: A computer simulation study. J Am Dent Assoc
2015;146:735–742.
38. Urban T, Kostopoulos L, Wenzel A. Immediate implant placement in molar regions: A 12-month prospective, randomized
follow-up study. Clin Oral Implants Res 2012;23:1389–1397.
39. Jensen SS, Terheyden H. Bone augmentation procedures in localized defects in the alveolar ridge: Clinical results with dierent bone grafts and bone-substitute materials. Int J Oral Maxillofac Implants 2009;24(suppl):218–236.
231231
Page references followed by “f ” denote gures; “b” denote boxes;
and “t” denote tables.
A
Absorbent collagen sponge, 146
ACM. See Autogenous bone collector.
Actinomycosis, 82
Allograft, freeze-dried bone, 9
All-on-4, 1
Alveolar recess, maxillary, 33, 33f
Alveolar ridge
augmentation of. See Vertical ridge augmentation.
plastic deformation of, 119–120
shrinkage of, after extractions, 3
Apical periodontitis, 82
Atraumatic tooth extraction. See also Tooth extraction.
importance of, 141, 209
of mandibular molars, 45–46
of maxillary molars, 68, 221f
Autogenous block grafts
ring blocks with bone and dentin, 100–102, 101f
vertical ridge augmentation using, 100
Autogenous bone collector, 108, 110, 110f
Autograft, 7f
Autologous brin glue, 103
Autologous platelet-rich brin clots, 14, 15f
B
BIC. See Bone-to-implant contact.
Bicon implants, 154f, 162f
Bicon reamer, 157f
Bio-Oss, 6
Bisphosphonates, 9
Bone-to-implant contact, 205–206
Brånemark-type endosseous implant, 137, 203
Buccal onlay grafting, 3f
Buccal plate, implant malpositioned too close to, 220–221,
221f
Bundle bone, 188
C
CAIS. See Computer-assisted implant surgery.
Caries
interproximal, 191–192
predisposing factors, 223, 223f
Complications
anatomical, 225–226, 225f–226f
failure to place implant centrally in socket, 221, 222f
guided bone regeneration, 227, 227f
inappropriate spacing between implant and adjacent teeth,
223–224, 223f–224f
keratinized soft tissue width and thickness inadequacies,
225
lingual plate perforation during osteotomy preparation, 227,
227f
malpositioning too close to buccal plate, 220–221, 221f
mandibular canal violations, 226, 226f
overseating, 222f, 222–223
positioning-related, 220–224, 221f–224f
procedure-related, 227
sinus-related, 225f, 225–226
underseating, 222–223, 223f
Computed tomography
advantages and disadvantages of, 24t
cone beam. See Cone beam computed tomography.
Computer-assisted implant surgery
accuracy benets of, 168
advantages of, 168–169, 169f
cone beam computed tomography in, 168, 173, 173f
description of, 168
dynamic, 170
freehand surgery versus, 168, 169f
fully guided, 172
guide support type, 171, 171f
half-guided, 172
implant location and selection, 174
indications for, 168–169
jaw scanning, 173, 173f
limitations of, 169
static navigation, 170–171, 177, 178f
summary of, 179
INDEX
INDEX
232
surgical guides
closed, 171–172
description of, 169
owchart for, 175f
open, 171–172, 172f
preparation of, 174–175, 175f
printing of, 176, 176f
wax-up for, 176f
surgical procedure, 176–179, 176f–178f
types of, 170–172
Concentrated growth factor, 51, 70–71, 86, 103
Cone beam computed tomography
advantages of, 24t
computer-assisted implant surgery uses of, 168, 173, 173f
cortical bone thickness assessments, 44
description of, 10, 23
DICOM images, 173f
disadvantages of, 24t
immediate mandibular molar implants, 29f
osseodensication applications of, 120
Convergent jaw, 42, 43f
Crestal bone
immediate molar implants and, 16
for immediate nonocclusal loading, 204
stability of, 162f
Cross-arch-stabilized xed immediate prostheses, 203
D
Decoronation, 12, 50f, 61f, 88, 143f, 190f
Delayed implant placement, 2, 2t, 5, 16, 82, 210
Delayed occlusal loading, 204, 208
Densah burs, 5, 118–119, 118f–119f, 124f, 193–194
Dentin, demineralized, 102
Dentin graft particles, 7
Diamond bur, 11f, 45
Distraction osteogenesis, 99–100
DO. See Distraction osteogenesis.
Dynamic computer-assisted implant surgery, 170
E
Early implant placement, 2t, 2–3, 219
Early occlusal loading
denition of, 204
of molar implants, 205
EMD. See Enamel matrix derivative.
Enamel matrix derivative, 188
Endosseous implants, 137, 167
Expanded polytetrauoroethylene membrane, 62, 62f, 81
F
FDBA. See Freeze-dried bone allograft.
Fixed partial provisional restorations, 206
Flapless surgery
description of, 120, 176
gap grafting and, 182–183
illustration of, 183f–184f
Free gingival graft, 14, 15f
Freehand surgery
computer-assisted implant surgery versus, 168, 169f
disadvantages of, 169f
Freeze-dried bone allograft, 9
Full-thickness aps, 103
Fusobacterium nucleatum, 84
G
Gap grafting
case examples of, 184–187, 185f–186f
description of, 13–14, 14f–15f
apless surgery and, 182–183
owchart for, 187f
immediate maxillary molar implants, 75f, 76
indications for, 187–188
literature review regarding, 182
Gingival biotype, 2, 13, 225
GORE-TEX expanded polytetrauoroethylene barrier, 9
Granulation tissue, 4
Guided bone regeneration
case report of, 112f
complications associated with, 227, 227f
description of, 4, 6, 84, 219
immediate molar implants and, 95, 95f–96f
membrane exposure associated with, 227, 227f
vertical ridge augmentation using, 100
H
Hand osteotomes, 226
Healing abutments, 4, 124, 146f, 205, 209
HPISE tip. See Hydrodynamic piezoelectric internal sinus
elevation tip.
Hydrodynamic piezoelectric internal sinus elevation tip, 70
25-Hydroxyvitamin D, 9
233
INDEX
I
IAC. See Inferior alveolar canal.
IMI. See Immediate molar implant.
Immediate implant placement, 219
Immediate loading
contraindications for, 204b
crestal bone requirements for, 204
denition of, 204
early research on, 203–204
xed partial provisional restorations with, 206
of immediate molar implants
advantages of, 205–206
case reports, 209–214, 209f–214f
challenges associated with, 207–208
clinical protocols for, 208–214
outcomes of, 206
immediate placement and, 207–208
nonocclusal, 204–205
occlusal, 204
prosthetic considerations for, 204
of single implants, 204, 206
Immediate mandibular molar implants
alternatives to, 41
atraumatic molar extraction for, 45–46
case selection for, 40
cone beam computed tomography of, 29f
cortical bone thickness in, 44, 44f
ap design for, 45
owchart for, 55f
gap management for, 54
in interradicular septum bone
anatomy of, 40–42, 41f
description of, 88
osteotomy drilling before root removal, 48–53, 48f–53f
osteotomy preparation, 46f, 46–47
site preparation, 46f, 46–47
type A, 40–41, 41f, 46
type B, 41, 41f, 43f, 46–47, 47f, 128–129, 129f–130f
type C, 41, 41f–42f, 46
lingual plate perforation, 43
mandibular ridge morphologies, 25, 26f, 42–44, 43f
nonsubmerged healing of, 54
osseodensication for, 120, 121f
placement of
antibiotic prophylaxis before, 44–54
inferior alveolar nerve damage during, 30
plateau root form implants as, 160–161, 160f–161f
primary stability, 28, 29f
protocols for, 8–9
radiographic screening for
buccal cortical plate thickness, 26f, 27–28
interroot distance between adjacent teeth, 30–31
lingual concavities, 26f, 27
lingual plate thickness, 26f, 27–28
mandibular ridge morphology, 25, 26f
periapical pathology, 30f, 31
root apex to canal distance, 29f, 29–30
root morphologies, 28, 28f
septal bone in furcation area, 28–29, 29f
second molars, 7f, 52, 52f
sockets
classication of, 40–41, 41f
debridement of, 46
type B, 123–125, 123f–125f
studies of, 39–40
submerged healing of, 54
surgical protocols for, 44–54
systematic literature reviews on, 39–40
3D positioning of, 47–48
Immediate maxillary molar implants
abutments in, 76
atraumatic extraction for, 68
case selection, 63
decoronation, 61f
rst molar, 65f, 66, 69f, 73f
ap design for, 68
apless approach for, 68
owchart for, 77f
gap grafting for, 75f, 76
in interradicular septum bone
anatomy of, 66, 67f
case study, 93, 93f
coronal width of, 69
description of, 32, 34f, 35, 32f, 88
type A, 66, 67f, 130–133, 131f–133f
type B, 66, 67f, 72
type C, 66, 67f
widths of, 62
literature review on, 59–63, 60f–63f
mucoperiosteal aps for, 60–61
in nonsmokers, 63
osteotomy preparation, 68–76, 69f–75f
outcomes of, 62
periapical pathology eects on, 35, 35f, 60
plateau root form implants as, 156–159, 157f–159f
protocols for, 4–5, 8–9, 60, 68–76
radiographic screening for
alveolar recess, 33, 33f
overview of, 31, 31t, 64f
periapical pathology, 35, 35f, 60
root apex distance to sinus oor, 33, 32f
root intrusion into sinus, 34f, 35
sinus and molar apices in sagittal plane, 33, 35
socket measurements, 32–33, 32f–33f
root apex distance to sinus oor measurements, 33, 32f
root apices of molar teeth in sagittal plane considerations,
33, 35
INDEX
234
sinus oor elevation and, 69–70, 71f
sinus grafting with, 63
sockets
anatomy of, 64–65, 65f
debridement of, 61, 68
maxillary sinus proximity of, 64–65
radiographic measurements of, 32–33, 32f–33f
studies of, 59–63, 60f–63f
success factors for, 64
success rates for, 219
summary of, 77
survival rates for, 63
treatment planning of, 63
vertical root fracture, 72, 73f–74f
wound closure in, 76
Immediate molar implants
adjacent teeth and, inappropriate spacing between, 223–
224, 223f–224f
advantages of, 82
atraumatic tooth extraction for, 141
barrier material for, 81–82
buccal onlay grafting, 3, 3f
case report of, 6–8, 6f–8f
case selection for, 9–15, 11f–14f
complications of. See Complications.
computer-assisted implant surgery for placement of. See
Computer-assisted implant surgery.
contraindications for, 5–10, 6f–8f
crestal bone loss and, 16
customized abutments for, 204, 213f
delayed implant placement versus, 16
design features for, 12–13
diameter of, 12–13
early studies of, 8, 203–204
early work with, 3–5
extraction technique for, 10–12
apless surgery for, 120, 176
free gingival graft coverage of, 14, 15f
in fresh extraction sockets, 16
gap grafting, 13–14, 14f–15f
gingival biotype and, 2, 13, 225
guided bone regeneration and, 95, 95f–96f
history of, 8–9, 23, 81, 181–182
immediate loading of
advantages of, 205–206
case reports, 209–214, 209f–214f
challenges associated with, 207–208
clinical protocols for, 208–214
outcomes of, 206
in interradicular septum bone, 5, 11 11f
malpositioning of, too close to buccal plate, 220–221, 221f
marginal bone gaps around, 3
micromotion of, 117
osteotomy preparation for, 10–12, 11f–12f
overseating of, 222f, 222–223
performance of, 16–17
positioning of
buccal plate considerations, 220–221, 221f
failure to place centrally in socket, 221, 222f
in posterior mandible, 110, 111f
primary stability of, 117–118, 120, 204–205
principles for, 220
rationale for, 3–5
requirements for, 219–220
short implants as. See Short implants.
single-rooted teeth treated with, 4
site healing of, 220f
site selection for, 10
soft tissue management after placement, 13–14
stability/stabilization of, 2, 5, 5f, 11f, 82, 117, 122, 208
studies of, 9, 117
subcrestal placement of, 13
success rates for, 16–17
survival rates for, 23
systematic review of, 117
teeth adjacent to, inappropriate spacing between, 223–224,
223f–224f
ultra-wide. See Ultra-wide immediate molar implants.
underseating of, 222–223, 223f
vertical ridge augmentation and, 108–111, 108f–112f
well-positioned, 220f
wider-diameter, 12–13, 120, 207
wound closure, 13–14
Implant placement
classication of, 219
delayed, 2, 2t, 5, 16, 82, 219
early, 2, 2t, 210
immediate, 219
timing of, 1–3, 2t
type 1, 2, 2t
type 2, 2t, 2–3
type 3, 2t, 2–3
type 4, 2, 2t
Implant placement immediate, 219
Implant stability quotient, 125, 205
Implant-tooth distance, 191–192, 192f
Indirect sinus oor elevation, 192–194, 193f–194f
Infected molar sockets, immediate implant placement in
acute versus chronic infection, 84
antibiotic prophylaxis, 86
case studies of, 89–95, 89f–95f
clinical protocols for, 88–89
failures, 85–86
apless surgery in, 88
indications for, 82
laser decontamination of, 88
literature review regarding, 83–88
235
INDEX
mandibular molars
with endodontic complications, 91–92, 92f
rst, 89, 91f
maxillary molars
with chronic infection, 93–95. 93f–94f
rst, 89, 89f–90f
overview of, 81–82
platelet-rich plasma with, 86, 87f
studies of, 83–88
success factors for, 87–88
survival rates for, 85
Inferior alveolar canal, 26f, 27, 42
Inferior alveolar nerve
damage to
description of, 28–30, 42, 91
in immediate mandibular molar implant, 42, 163
lacerations, 163
root apex to canal distance, 29
Insertion torque values, 118, 122, 183, 208
International Team for Implantology Consensus Group, 219
Interproximal caries, 191–192
Interradicular septum bone
description of, 4, 5f
immediate mandibular molar implant in. See Immediate
mandibular molar implants, in interradicular septum bone.
immediate maxillary molar implant in. See Immediate
maxillary molar implants, in interradicular septum bone.
in mandibular molars, 28, 29f
in maxillary molars, 34f, 35
osseodensication expansion of, 122f
preservation of, during tooth extractions, 118
radiographic evaluation of, 23
type A
case report of, 126–127, 126f–127f
description of, 11, 12t, 13, 120, 141
immediate mandibular molar implants in, 40–41, 41f, 46
immediate maxillary molar implants in, 66, 67f
radiographic screening of, 34f, 35
type B
description of, 11–12, 12t, 13, 120, 209, 209f
immediate mandibular molar implants in, 41, 41f, 43f, 46,
128–129, 129f–130f
immediate maxillary molar implants in, 66, 67f, 72
maxillary MAX implant placement in, 141–142
radiographic screening of, 34f, 35
type C
description of, 12t, 120
illustration of, 178f, 186f, 222f
immediate mandibular molar implants in, 41, 41f–42f, 46
immediate maxillary molar implants in, 66, 67f
maxillary MAX implant placement in, 141
radiographic screening of, 34f, 35
static computer-assisted implant surgery in, 177, 178f
width of, 122f
Intrasulcular incisions, 10
IRS. See Interradicular septum bone.
ISQ. See Implant stability quotient.
ITD. See Implant-tooth distance.
ITVs. See Insertion torque values.
J
Jaw scanning, 173, 173f
Jumping distances, 181
L
Latch reamers, 161f
Leukocyte-rich brin clots, 124
Lingual concavities
immediate mandibular molar implants, 26f, 27
type I, 26f, 27
type II, 26f, 27
type III, 26f, 27
Lingual plate perforation, 26f, 27, 43, 227, 227f
Loading
delayed occlusal, 204, 208
immediate. See Immediate loading.
M
Mandibular canal, 226, 226f
Mandibular molars
adjacent, interroot distance between, 30–31
atraumatic extraction of, 45–46
bone loss after extraction of, 105f
endodontic complications with, 91–92, 92f
rst, 30f, 47f–48f, 90, 91f, 105f
immediate implants. See Immediate mandibular molar
implants.
interradicular septum bone in, 28, 29f
lingual plate perforation in, 43
MAX implant, 147–149, 148f–149f
pathology of, 30f, 31
periapical infection of, 30f, 31
root apex to canal distance for, 29f, 29–30
root morphology of, 28, 28f
second, 29f, 47f, 52, 52f, 101f, 103f
single implants, 206
type B socket with, 123–125, 123f–125f
Mandibular ridge
morphology of, 25, 26f, 42–44, 43f
undercut, 25, 26f, 42–44, 43f
vertical augmentation of. See Vertical ridge augmentation.
INDEX
236
MAX implant
cone beam computed tomography applications, 140–141,
146f
description of, 138
design of, 138, 139f
dimensions of, 139f
literature review regarding, 138–140
mandibular, 147–149, 148f–149f
maxillary, 141–147, 142f–147f
placement protocols for, 140–149
studies of, 138–140
success rate for, 139
tap device for, 144f
Maxillary molars
atraumatic extraction of, 221f
rst, 32f, 65f, 89, 143f, 196, 197f
immediate implants for. See Immediate maxillary molar
implants.
MAX implant, 141–147, 142f–147f
periapical pathology of, 35, 35f
root intrusion into sinus, 34f, 35
second, 186f
Micromotion, 117, 205
Molar implants
delayed loading of, 206
immediate. See Immediate molar implants.
Mucogingival ap, 88
Mucoperiosteal ap, 10
O
Osseodensication
anatomical considerations for, 120–122
burs for, 118–119, 118f–119f
cone beam computed tomography applications, 120
description of, 5, 46f, 117–118
immediate mandibular molar implant placement using, 120,
121f
indirect sinus oor elevation applications of, 192–194,
193f–194f
literature on, 119–120
in mandibular molars
with type B septum, 128–129
with type B socket, 123–125, 123f–125f
in maxillary molars
with sinus oor elevation, 130–133, 131f–133f
with type A septum, 130–133, 131f–133f
with type A socket, 126–127, 126f–127f
mechanism of, 119–120
summary of, 134
surgical considerations for, 120
trabecular bone deformation through, 120, 134
Osteitis, 94f
Osteocytes, 205
Osteotomy preparation
for immediate mandibular molar implants, 46f, 46–47
for immediate molar implants, 10–12, 11f–12f
lingual plate perforation during, 227, 227f
osseodensication for, 118
sinus perforation prevention, 226
technique for, 142, 143f
tooth root removal before, 12, 12f
Overhanging restorations, 223
Overseating, 222f, 222–223
P
Panoramic radiographs, 24t
Parallel jaw, 42–43, 43f
Partial extraction therapy, 188
Particulate graft, 6–7
PEEK abutment, 146, 146f
Peptostreptococcus micros, 84
Periapical infection, 30f, 31, 224
Periapical radiographs, 24t
Peri-implant gaps, 54, 182, 209, 210f, 221
Periodontal ligament, 188
Periodontitis, 9
Periradicular infection, 82
Plasma rich in growth factors, 86–87, 89
Plateau root form implants
complications of, 163
description of, 153, 154f
immediate molar implant use of, 155
mandibular placement of, 160–161, 160f–161f
maxillary placement of, 156–159, 157f–159f
Platelet-rich brin, 6–7, 9, 14, 15f, 51, 86, 91, 184
Platelet-rich plasma, 86, 87f
Platform switching, 47
Polyaryletherketone cylinder, 212
Polytetrauoroethylene nonresorbable barrier, 7, 7f, 9, 82
Polytetrauoroethylene sutures, 51
Press-t immediate molar implants
advantages of, 153
complications of, 163
general concepts with, 153–155
plateau root form implants. See Plateau root form implants.
screw root form implants, 154
socket wall fractures, 163
studies of, 155–156
PRF. See Platelet-rich brin.
PRGF. See Plasma rich in growth factors.
Primary stability, 117–118, 120, 204–205
Provisional restorations, xed partial, 206
P R P. See Platelet-rich plasma.
237
INDEX
R
Radiographic screening
advantages of, 23t
disadvantages of, 23t
for immediate mandibular molar implants. See Immediate
mandibular molar implants, radiographic screening for.
for immediate maxillary molar implants. See Immediate
maxillary molar implants, radiographic screening for.
overview of, 23–24
panoramic radiographs, 24t
periapical radiographs, 24t
3D imaging versus, 24
Receptor activator of nuclear factor kappa-B ligand, 9
Rescue implants, 195, 198
Ring blocks with bone and dentin, 100–102, 101f
Running room, 222–223
S
Sandwich augmentation, 100
Screw root form implants, 154
Short implants
case examples of, 195–197, 196f–197f
description of, 195
reliability of, 198
research on, 198, 199f
Single mandibular molar implants, 206
Sinus
complications associated with, 225f, 225–226
grafting of, with immediate maxillary molar implants, 63
penetration of, 225–226
Sinus oor elevation
indirect, 192–194, 193f–194f
maxillary molars with, 130–133, 131f–133f
osseodensication for, 192–194, 193f–194f
Site selection, 10
Socket(s)
anatomy of, 120
healing of, particulate graft eects on, 6
immediate mandibular molar implants
classication of, 40–41, 41f
debridement of, 46
type B, 123–125, 123f–125f
immediate maxillary molar implants
anatomy of, 64–65, 65f
debridement of, 61, 68
maxillary sinus proximity of, 64–65
radiographic measurements of, 32–33, 32f–33f
infected. See Infected molar sockets.
mandibular, 28, 29f
preservation of, 6, 6f
Socket preservation grafting, 64
“Socket seal” technique, 88
Socket shielding
procedure for, 189–191, 189f–190f
purpose of, 188–189
Stability
of crestal bone, 162f
measuring of, 208
primary, 117–118, 120, 204–205
of wider-diameter implants, 207
Static computer-assisted implant surgery, 170–171, 177, 178f
Stereolithography, 173
“Sticky bone,” 7, 7f, 193, 194f
Subcrestal implant, 174
Submerged implants, 206
Surgery
computer-assisted. See Computer-assisted implant surgery.
apless. See Flapless surgery.
Surgical elevators, 11f
Surgical guides
closed, 171–172
description of, 169
owchart for, 175f
open, 171–172, 172f
preparation of, 174–175, 175f
printing of, 176, 176f
wax-up for, 176f
T
readed implants, ultra-short, 198
Titanium abutment, 209
Titanium mesh, 100
Tooth extraction. See also Atraumatic tooth extraction.
alveolar ridge shrinkage after, 3
buccal bone loss after, 5
ap for, 6
molar septum preservation during, 118
technique for, 10–12
Trabecular bone deformation, 120, 134
Transgingival healing abutments, 191
Type 1 implant placement, 2, 2t
Type 2 implant placement, 2t, 2–3
Type 3 implant placement, 2t, 2–3
Type 4 implant placement, 2, 2t
Type A interradicular septum bone
description of, 11, 12t, 13, 120, 141
immediate mandibular molar implants in, 40–41, 41f, 46
immediate maxillary molar implants in, 66, 67f, 130–133,
131f–133f
maxillary MAX implant placement in, 141
radiographic screening of, 34f, 35
Type B interradicular septum bone
description of, 11–12, 12t, 13, 120, 209, 209f