Immediate post-extraction implant in the molar region using a new implant with the technique of intraradicular preparation and alveolar preservation

Abstract

Tooth extraction is inevitably accompanied by a resorption in the alveolar crest. Procedures on condemned teeth in the posterior region tend to be neglected because they are not in an aesthetic area, resulting in greater tissue loss after tooth extraction. By using immediate approaches, there is a significant reduction in the reabsorption of the remaining tissues, promoting greater stability in implant-supported rehabilitation with regard to the height of the gingival margin and avoiding prosthetic crowns with over-contour. Among them, the immediate implant associated with bone grafting may be a viable option for maintaining bone architecture. Thus, the objective of this case report is to present the advantages of using implants with macrostructure favorable to the immediate installation of implants in the posterior region of the mandible. Female patient, 42 years old, without systemic involvement, attended the dental clinic for rehabilitation of the region of tooth 46 with dental implant, due to coronary destruction. We opted for the installation of an implant with high primary stability (Epikut Plus^®, S.I.N. Implant System, São Paulo, Brazil), associated with filling the gap with xenogenous bone graft and sealing the alveolus with a polymer-based customized healing abutment. In a 30-day postoperative period, good tissue healing and keratinized tissue gain were observed. In a 2-month postoperative control, the tissue quality provided perfect tissue maintenance, enabling a quality soft tissue for conditioning the peri-implant mucosa during the provisionalization period. After 3 months of treatment, a periapical radiograph was requested and a screwed prosthesis was made over the implant. Through the proposed technique it was possible to guarantee the implant installation immediately after tooth extraction with good primary stability provided by the implant macrogeometry and shorten the healing time due to the bioactivity of the HAnano coating.