Immediate Implant Placement in Maxillary Molars using Threaded Expanders

Cesar Luchetti, Gregori Kurtzman and Alicia Kitrilakis

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Immediate Dental Implants After Extraction - Video

Cesar Luchetti

Department of Implant Dentistry. National University of La Plata. Argentina

This case is from a middle age woman with periodontal compromise in the anterior teeth. The video shows the immediate implant placement for the upper anterior area. The lower anteriors, two implants at laterals, were done in the same surgery but are not presented here.

Please, click on SEE ON HD (High Definition) option to see the video better. Or HQ button from the menu on the lower right.

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Immediate Implant Placement in Upper 2nd Premolar

Cesar Luchetti

Department of Implant Dentistry. National University of La Plata. Argentina

The immediate implant placement is today a routine approach. However, it must fulfill a series of conditions, between which is the achievement of a good initial anchorage, like in conventional implantology. This initial fixation normally is looked for creating the bed beyond the apex of the extracted piece, that is why some colleagues also denominate them trans-alveolus immediate implants.

Nevertheless, in certain situations it is not possible to go beyond the apex, due to anatomical limitations, as in the case of the upper second premolars and its proximity with the maxillary sinus.

Here we presented a case of immediate placement where the anchorage is obtained by means of the sidewalls of the residual alveolus.

Pre-operative situation. Root non-recoverable.

In the x-ray, the intimate relation of contact

between the apex of the piece and the cortical

of the maxillary sinus is observed.

After extraction socket with oval shape.

We decide the direct placement, without using

other instrument to modify the socket.

An implant of 4.5 mm of diameter (Steri-Oss)

was chosen to maximize the contact with the

mesial and distal walls.

The residual spaces are completed with a

bovine hidroxyapatite graft and soft tissue

closure was obtained with a partial thickness

palatal flap. X-ray shows the intimate position

of the implant respect the sidewall and the floor

of the maxillary sinus.

Implant uncovering and placement of the

definitive abutment

Metal substructure try in and definitive

metal-ceramic crown in place

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Immediate Implant Placement in Upper Incisor Area

Cesar Luchetti

Department of Implant Dentistry. National University of La Plata. Argentina

We are presenting a case of immediate implant placement in an upper incisor. Twenty years old patient came to us presenting mobility of the upper right central incisor with compromised esthetics. He has an antecedent of exfoliation and re-implantation during his childhood due to a bike accident. X-rays showed root resorption. We decide the extraction followed by an immediate implant placement.

Pre-operatory situation.

The tooth is extracted and the root

resorption is visualized.

The bone presents loss of the buccal wall.

An osteotome preparation is performed in

order to expand the bone and then

the implant is placed.

 

A small autogenous bone graft is placed in

the buccal side.

 

Suture. Coronal repositioned flap is used to

compensate the soft tissue deficiency present

at pre-operative stage

 

After two months, 2^nd stage surgery is

performed together with a micro-polishing of

the gum’s surface to improve the future esthetics.

After seven days the tissue is healed

and the abutment is placed.

Definitive porcelain crown, together with a

small angle reconstruction with composite of

the adjacent central incisor.

 

Pre and post comparison.
The management and improvement of the

tissues contour, both hard and soft, played a

major role in the esthetic obtained.

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