Journal of Oral Implantology April 2014 - (Page 211)

CASE LETTER Three-Year Follow-Up of a Single Immediate Implant Placed in an Infected Area: A New Approach for Harvesting Autogenous Symphysis Graft Aladdin J. Al-Ardah, DDS, MS1* Fawaz Alqahtani, BDS, MDS2 Jaime L. Lozada, DMD1 INTRODUCTION A restoration in the anterior region of the mouth is challenging from the surgical and the prosthetic point of view. The goal of implant therapy today is not only to attain osseointegration of the implant but also to enhance and maintain the soft tissue esthetics around dental implants. Maintaining the soft tissue architecture around the implant restoration to mimic the contralateral tooth in the anterior esthetic area is required for a successful restoration. Immediate implant placement and provisionalization maintains the soft and hard tissue architectures, avoids the need for additional surgeries, and shortens treatment time.1-3 Clinical trials showed a high success rate of immediate implant placement in fresh extraction alveolus.4-6 Careful analysis of soft and hard tissue is a prerequisite for immediate implant placement in the anterior region of the mouth.7 Kois8 named 5 diagnostic factors used to assist in predictable immediate implant placement. Of the 5 diagnostic factors, 3-that is, the form, biotype of the periodontium and height of the alveolar crest before tooth extraction-address the importance of soft and hard tissue components. Presence of an active apical and/or periodontal 1 Advanced Education Program in Implant Dentistry, Department of Restorative Dentistry, Loma Linda University School of Dentistry, Loma Linda, Calif. 2 Department of Prosthetic Dental Sciences, Salman bin Abdulaziz University School of Dentistry, Al-Kharj, Saudi Arabia, and Advanced Education Program in Implant Dentistry, Department of Restorative Dentistry, Loma Linda University School of Dentistry, Loma Linda, Calif. * Corresponding author, e-mail: aalardah@llu.edu DOI: 10.1563/AAID-JOI-D-13-00202 infected residual socket may be considered a relative contraindication for the immediate implant placement.9 An infected alveolus confirms the presence of bacteria that will induce inflammatory activity, increase the bone resorptive process, and result in a higher risk of implant failure.10 Lindeboom et al 11 compared the survival rate of immediate and delayed implant placement into infected residual alveolus. The author showed a 92% survival rate of immediately placed implants compared with a 100% survival rate of delayed placement implants. Additionally, there was more midbuccal soft tissue recession in the immediate placement compared with the delayed placement protocol 1 year after placement. Another study by Seigenthaler et al12 demonstrated an equal survival rate of the immediate and delayed implant placement into infected alveolus. Complete debridement of the alveolus with primary stability of the implant is a prerequisite for immediate placement. Immediate placement of an implant in the presence of a chronic infection and a deficient buccal plate in a patient with a high smile line is very challenging and complex. Autogenous bone graft harvested from intraoral or extraoral sites has been used for predictable guided bone regeneration.13,14 Certain complications of the donor sites have been reported.15,16 The purpose of this clinical report is to discuss the surgical and restorative protocols for immediate implant placement and provisionalization in the presence of a large periodontal abscess with a buccal plate defect in an area that demands attention to esthetics using a novel technique for harvesting an autogenous mandibular symphysis graft with a single vertical incision. Journal of Oral Implantology 211

Table of Contents for the Digital Edition of Journal of Oral Implantology April 2014

Consolidated Standards of Reporting Trials (CONSORT): Answering the Call for JOI’s Endorsement
Photoelastic Analysis of Stress Distribution With Different Implant Systems
Influence of Abutment Screw Design and Surface Coating on the Bending Flexural Strength of the Implant Set
Comparison of Implant-Abutment Interface Misfits After Casting and Soldering Procedures
Evaluation of Accuracy of Casts of Multiple Internal Connection Implant Prosthesis Obtained From Different Impression Materials and Techniques: An In Vitro Study
The Effect of Different Implant-Abutment Connections on Screw Joint Stability
Effects of pH and Elevated Glucose Levels on the Electrochemical Behavior of Dental Implants
Finite Element Analysis of Provisional Structures of Implant-Supported Complete Prostheses
Saliva Versus Peri-implant Inflammation: Quantification of IL-1b in Partially and Totally Edentulous Patients
Heat Generated During Seating of Dental Implant Fixtures
An Alternative Approach for Augmenting the Anterior Maxilla Using Autogenous Free Gingival Bone Graft for Implant Retained Prosthesis
Nasopalatine Duct Cyst, a Delayed Complication to Successful Dental Implant Placement: Diagnosis and Surgical Management
The Custom Endosteal Implant: Histology and Case Report of a Retrieved Maxillary Custom Osseous-Integrated Implant Nine Years in Service
Occlusal Concepts Application in Resolving Implant Prosthetic Failure: Case Report
Three-Year Follow-Up of a Single Immediate Implant Placed in an Infected Area: A New Approach for Harvesting Autogenous Symphysis Graft
Use of Stress Analysis Methods to Evaluate the Biomechanics of Oral Rehabilitation With Implants

Journal of Oral Implantology April 2014