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ePaper created 2015-11-17, 15:11:47 | version 1.38.0
Volume 1 | Issue 1/2015 09Journal of Oral Science & Rehabilitation P eriim planti ti s: Imme di ate i mplant re place me nt implantitis.13 The prevalence of periimplantitis varies between different studies and a preva- lence (implant based) of 6.6–36.6% has been reported.14–18 Dental implant extraction may be indicated in cases of advanced bone loss around the implant. Inthese cases, could immediate im- plantreplacementbeconsidered? No studyhas reported on immediate implant placementaftertheextractionofinfecteddental implants.Thisdearthcouldberelatedtotheneed for a predictable technique that permits conser- vative implant extraction that preserves most of theviable soft and hardtissue.Atthe sametime, thetechnique should not damagethe bonywalls of the socket and thereby compromise the os- seointegration of the new dental implant. A kit forimplantextractionhasbeendevelopedtoful- fill the above-mentioned requirements and to enhance the possibility of achieving adequate implantstability.1,19 A clinical protocol that aims to decrease the bacterial load by curetting and decontamination ofthesocket,maintaintheregenerativecapacity of the surrounding alveolar walls, and achieve primary stability would result in favorable out- comes for immediate replacement offailed den- tal implants. In this article, we analyze the out- comesofthisclinicalprotocol.Tothatend,failed, nonmobile, infected dental implants were ex- tracted using an implant extraction kit and new implants were immediately placed in replace- mentofthese.Plasmarichingrowthfactorswas placed in the explantation socket before implant placement. The extracted dental implants were analyzed under a scanning electron microscope andthepatientswerefollowedforfouryears. Materials&methods O u tco me cr i te r i a Inordertoachievetheobjectivesofthestudy,de- mographic and anamnesis data were obtained from the patients’ records. Implant failure was defined as any implant lost owing to failure to achieve osseointegration or to loss of acquired osseointegration. The patient was the statistical unitforthedescriptionofdemographicdata.The implant was the statistical unit forthe statistical description of implant location and removal torque. For the new implants, data on insertion torque, failure and marginal bone loss were col- lected.Implantlengthwasusedasareferenceto calibrate the linear measurements on the digital panoramicradiograph.Implantsurvivalratewas analyzed using the Kaplan–Meier method. All the statistical analyses were performed using theSPSSforWindowsstatisticalsoftwarepack- age(Version15.0;SPSS,Chicago,Ill.,U.S.). Fig. 1 (a) A nonmobile implant with advanced bone loss due to periimplantitis. (b) An extraction ratchet placed into the implant connection. (c) Implant removal by application of counterclockwise torque. (d) The dental implant placed after careful curettage of the socket. Fig. 1 a b c d