Guided immediate implant placement in molar extraction sites : a 1-year prospective pilot study.

Description :

This project involves immediate implant placement in molar sites while achieving optimal primary stability. Preoperative 3D radiographs (cone beam computed tomography CBCT) and intra oral scans (IOS) will be taken. Careful planning will be carried out using "BlueSky Plan" and "R2Gate" (Megagen implant, Daegu, Korea) softwares to determine ideal implant position, ensuring maximum residual septal bone to implant contact. A customized printed PMMA healing abutment will be prepared following socket gingival contour in order to maintain ideal emergence profile for the future implant restoration. A temporary crown will also be planned and printed prior to the surgery. The choice of implant macrogeometry by selecting appropriate thread depth (MegaGen, AnyRidge) will be done during planning in order to ensure optimal primary stability. Guided implant placement will be performed and implant stability by means of ISQ measurements (Smartpeg Type 27, Osstell, Göteborg, Sweden) will be done at day 0, at 6 weeks and at 6 months. PMMA temporary crowns will be placed in occlusion at 6 weeks whenever ISQ values permit it. At 6 and 12 months, marginal bone loss (MBL) will be measured on sequential periapical radiographs taken with the long-cone paralleling technique, using customized (occlusal jig) commercial Rinn XCP holder (Rinn XCP, Dentsply, York, PA).