Immediate Implants In Infected Sockets: A Systematic Review
Ahmed Sadek El Sokkary;
Abstract
After thorough review of the literature the following protocol, we would recommend this protocol for immediate implant placement in infected sockets:
1. Chronic infection is not a contraindication for immediate implant placement. In case of acute infection, more research is recommended for the immediate implant placement in infected socket.
2. Preoperative administration of Chlorhexidine mouthwash and prophylactic antibiotic increased the success of osseointegration with insignificant value but it is recommended
3. The extraction technique should be as atraumatic as possible with the use of periotomes and luxators aiming at preserving the labial plate intact.
4. Whenever possible always decrease the need to raise a flap.
5. Ensure complete removal of intrasocket granulation tissue with thorough curettage and irrigation of the socket. Peripheral ostectomy and antibiotic irrigation are also recommended.
6. Implant should be placed in the esthetic triangle engaging the palatal bone.
7. Insufficient data was available regarding filling the gap between the implant and labial plate. But still, it is highly recommended by many authors to fill this gap.
8. Soft tissue augmentation using a connective tissue graft is recommended.
9. Whenever primary stability is adequate (35 N.cm or ISQ Value 70 ±4) it is recommended to immediately provisionalize with a screw retained crown which supports the soft tissue profile.
Soft tissue loss and pink esthetics evaluation was missed in most of the articles and it is recommended to evaluate and followup these parameters.
Literature regarding immediate implants in infected sockets revealed that this procedure has a good prognosis although it was controversial according to recommendations by articles published 15 – 20 years ago.
1. Chronic infection is not a contraindication for immediate implant placement. In case of acute infection, more research is recommended for the immediate implant placement in infected socket.
2. Preoperative administration of Chlorhexidine mouthwash and prophylactic antibiotic increased the success of osseointegration with insignificant value but it is recommended
3. The extraction technique should be as atraumatic as possible with the use of periotomes and luxators aiming at preserving the labial plate intact.
4. Whenever possible always decrease the need to raise a flap.
5. Ensure complete removal of intrasocket granulation tissue with thorough curettage and irrigation of the socket. Peripheral ostectomy and antibiotic irrigation are also recommended.
6. Implant should be placed in the esthetic triangle engaging the palatal bone.
7. Insufficient data was available regarding filling the gap between the implant and labial plate. But still, it is highly recommended by many authors to fill this gap.
8. Soft tissue augmentation using a connective tissue graft is recommended.
9. Whenever primary stability is adequate (35 N.cm or ISQ Value 70 ±4) it is recommended to immediately provisionalize with a screw retained crown which supports the soft tissue profile.
Soft tissue loss and pink esthetics evaluation was missed in most of the articles and it is recommended to evaluate and followup these parameters.
Literature regarding immediate implants in infected sockets revealed that this procedure has a good prognosis although it was controversial according to recommendations by articles published 15 – 20 years ago.
Other data
| Title | Immediate Implants In Infected Sockets: A Systematic Review | Other Titles | الغرسات الفوريه في الفجوات السنخيه الملوثه (مراجعه منهجيه) | Authors | Ahmed Sadek El Sokkary | Issue Date | 2017 |
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