This article on dental implantology from the Journal of Oral and Maxillofacial Surgery shows some very promising results with immediate placement of dental implants in the molar region.
“Clinical and Retrospective Evaluation of 4.1 or 4.3mm-Diameter Implants Placed Immediately in the Molar Region: A Preliminary Study”
Study conducted by Da-woon Jung, DDS, and Hyun-Joon Yoon DDS, PhD as presented in the Journal of Oral and Maxillofacial Surgery.
The study looks at 29 patients and 38 implants were placed and followed from 2007 to 2012. The implants were placed either in the maxilla or mandible with 50% in each. Implant diameter was 4.1 or 4.3 (regular platform). This is in contrast to commonly used “wide platform implants” in the 5mm width range.
Patients got pre-operative antibiotics (Amoxicillin) 1 hour prior to surgery and for 5 days following.
The surgeries were all by 1 experienced surgeon and torqued to 35N-cm.
The results showed 100% success in the maxilla and 94.7% success in the mandible (1 failed implant). Overall the statistical analysis gave a 97.4% 3 year survival of all immediate implants.
The study points out that previous studies (Himmlova et al) have looked at which size implant disperses stress best. Himlova found that the most critical change in stress (31.5%) was between 3.6 to 4.2mm diameter. Gaining diameter over 4.2 dispersed stress by an increase of 16%.
Take Home Messages:
- Immediate implants are a viable option, even in the posterior maxilla
- Regular diameter (~4mm) are equal to (or maybe even superior) to Wide diameter (~5mm) implants
- Splint your implants to other implants when possible, but un-splinted implants are ok too when there is not excessive load carried by that implant (canine guidance, group function etc.)
