STATEMENT OF PROBLEM: Infection in tooth extraction sites has traditionally been considered an indication to postpone implant placement until the infection has been resolved. PURPOSE: The aim of this study was to evaluate the survival rate of immediate and early-loaded implants placed immediately after extraction of teeth with endodontic and periodontal lesions or root fracture in the maxilla. MATERIAL AND METHODS: Thirty-three patients with teeth judged to be unrestorable because of endodontic or periodontal lesions or root fracture were included in the study. After tooth extraction, 1 to 6 implants (n=76) were placed in each patient using flap or flapless surgery in fresh extraction sockets, and a fixed provisional prosthesis was placed immediately or within 36 hours. Definitive prostheses were inserted after 6 to 12 months. The treatment protocol considered initial implant and prosthesis stability and control of the inflammatory response. Clinical and radiographic analyses were performed to evaluate the treatment outcome. Data were reported using descriptive statistics. RESULTS: After 1 year, 2 implants were lost, resulting in a 97.4% survival rate. A mean (SD) marginal bone loss of -0.91 (1.50) mm was recorded during the observation period. No signs of infection around the implants were detected at any follow-up visit. There was a tendency towards less bone loss with the flapless protocol, -0.74 (1.34) mm, versus flap, -1.02 (1.60) mm, and less bone loss for single, -0.55 (1.52) mm, versus multiple restorations, -0.86 (1.24) mm, with the flapless approach. CONCLUSIONS: A high 1-year survival rate was achieved for immediately placed and immediately/early-loaded implants in the maxilla, despite the presence of infection in the location of the extracted teeth.
STATEMENT OF PROBLEM: Infection in tooth extraction sites has traditionally been considered an indication to postpone implant placement until the infection has been resolved. PURPOSE: The aim of this study was to evaluate the survival rate of immediate and early-loaded implants placed immediately after extraction of teeth with endodontic and periodontal lesions or root fracture in the maxilla. MATERIAL AND METHODS: Thirty-three patients with teeth judged to be unrestorable because of endodontic or periodontal lesions or root fracture were included in the study. After tooth extraction, 1 to 6 implants (n=76) were placed in each patient using flap or flapless surgery in fresh extraction sockets, and a fixed provisional prosthesis was placed immediately or within 36 hours. Definitive prostheses were inserted after 6 to 12 months. The treatment protocol considered initial implant and prosthesis stability and control of the inflammatory response. Clinical and radiographic analyses were performed to evaluate the treatment outcome. Data were reported using descriptive statistics. RESULTS: After 1 year, 2 implants were lost, resulting in a 97.4% survival rate. A mean (SD) marginal bone loss of -0.91 (1.50) mm was recorded during the observation period. No signs of infection around the implants were detected at any follow-up visit. There was a tendency towards less bone loss with the flapless protocol, -0.74 (1.34) mm, versus flap, -1.02 (1.60) mm, and less bone loss for single, -0.55 (1.52) mm, versus multiple restorations, -0.86 (1.24) mm, with the flapless approach. CONCLUSIONS: A high 1-year survival rate was achieved for immediately placed and immediately/early-loaded implants in the maxilla, despite the presence of infection in the location of the extracted teeth.