Case Report
Immediate Implant Placement Following
Tooth Extraction-A Case Report.
Dr. Pushkar Gupta*, Dr. Harsh Chansoria**,
Dr. Shivakshi Chansoria*** , Dr. Arun Choudhary****
ABOUT THE AUTHORS
*Professor
Dept of Prosthodontics and
Crown & Bridge, Hitkarini
Dental College and
Hospital, Jabalpur,
Madhya Pradesh, India
**Reader
Dept of Prosthodontics and
Crown& Bridge,
Government college of
Dentistry, Indore, Madhya
Pradesh, India
***Reader
Department of Oral
Medicine Radiology, Index
Institute of Dental
Sciences, Indore Madhya
Pradesh
****PG student
Awadh Dental College and
hospital, Jamshedpur,
Jharkhand.
Address for Correspondence
Dr. Pushkar Gupta
Professor
Dept of Prosthodontics and
Crown & Bridge, Hitkarini
Dental College and Hospital,
Jabalpur, Madhya Pradesh, India.
Contact Number: 09406538208
Email- drpushkar1@gmail.com
All rights reserved
Abstract
A waiting period of 12 months or longer to allow total
socket healing used to be accepted protocol for placing implants.
The processes of modeling and remodeling that occurs following
tooth extraction result in pronounced resorption of various
components of the alveolar ridge. The use of immediate post
extraction implants presents several advantages in terms of
reduction of surgical steps and time required to conclude the
therapy. Particularly important is the possibility to minimize bone
loss that otherwise would occur in the physiologic healing of the
alveolus. This article aims to present a case report in which
immediate implant has been placed in maxillary central incisor
region.
Key words : Atraumatic extraction, immediate implant
placement, Fresh extraction socket
INTRODUCTION
Following extraction, healing period of four to six months has been
considered mandatory for implant placement.1 However, this procedure
leads to some volume of crestal bone resorption, loss of interpapillary
volume and eventual compromise in esthetics. A gradual diminishing of
the emerging profile is noticed 2 due to labial bony plate being resorbed at a
faster rate than remaining bone.
New protocols have been developed in which implants are placed at
the time of extraction of the tooth. Timing of implant placement following
tooth removal may be important and this concept has challenged the
original treatment protocol.3-5 In immediate implant placement, dental
implant is immediately placed into the fresh extraction socket so as to take
advantage of the healing potential of the bone. Studies indicate that
implants placed at the time of extraction have high success rates.6-8 This
clinical case report describes the procedure of immediate implant
placement.
CASE PRESENTATION
A 31 year old male patient reported to the outpatient department
(OPD), with the chief complaint of mobile upper front teeth. The patient
presented with a history of an accidental fall that happened 2 years prior to
this incident. On oral examination maxillary left central incisor was
JODE, Kolhan University (Jharkhand), Vol - 5 No.-1 January 2018 23
 Figure-1- Preoperative intraoral view
Figure-3- CT Scan Figure-4-Atraumatic extraction
Figure-6- Postoperative IOPAR
discolored with grade III mobility [Figure-1]. No
pain or fistula formation was noted. Intra Oral
Periapical radiograph (IOPAR) revealed horizontal
fracture in relation to 11 [Figure-2]. All the available
treatment options were discussed with the patient.
Finally, immediate implant placement was decided
and the patient's consent was taken.
The ideal implant length and diameter was
determined with CT scan [Figure-3]. It was decided
to place 13mm long and 5mm wide hydroxyapatite
coated implant (Bicon Dental Implant, Bicon,
Boston) into the socket of the freshly extracted tooth.
Patient was prepared for the implant placement.
After atraumatic extraction [Figure-4] osteotomy
site was prepared using sequential drills. Implant
was then placed at the osteotomy site. Cover screw
was placed and the implant site was sutured [Figure-
5]. Postoperative IOPAR was taken to see the
implant placement [Figure-6]. Clinical and
radiographic evaluation was done at one, two and
four months.
All rights reserved JODE, Kolhan University (Jharkhand), Vol - 5 No.-1 January 2018 24
Figure-2 –Preoperative IOPA
Figure- 5- Suture placed
Figure-7- Final prosthesis
After approximately four months second stage
surgery was performed which was followed by
cementation of metal ceramic crown [Figure-7].
DISCUSSION
Immediate implant placement protocol can offer
highly predictable results, which in clinical trials
have been shown to be as good as or even better than
traditional protocols. Studies with patient's
satisfaction clearly indicate that a substantial number
of patients were highly satisfied with immediate
implant supported prosthesis over fixed bridges and
soft tissue supported prosthesis. Minimally invasive
technique, ease of procedure and shorter time
involved together with minimum post-extraction
complications are the most important advantages of
this method. However, proper case selection and
meticulous postoperative care preceded by
goodsurgical and prosthetic protocol are the
essentials for success.

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