early implant placement 4-8weeks

Question 1

Risk factors for good esthetics

Answer 1

-thin tissue biotype
-thin facial bone
-dehiscence of the facial bone
-malposition of the implant.

Question 2

disadv for immediate implant

Answer 2

-Morphology of the site may increase the difficulty of placing an implant in an ideal position
-Morphology of the site may compromise initial implant stability
-Lack of soft tissue volume makes attainment of tension-free primary closure more difficult
-Increased risk of marginal mucosal recession
-Inability to predict bone modeling may compromise outcomes

Question 3

adv for early implant type 2

Answer 3

1) additional 3-5mm of KM
2) thickening of tissue by 7 fold (Chappuis) which helps with a) tension-free closure and b) enhanced vascularity for better healing and c) better esthetics and d) reducing the need for CTG
3) resolution of infection
4) gain of apical bone which can help w primary stability
5) Reduced treatment time

Question 4

adv for early type 3 placement

Answer 4

-Partial bone healing usually allows implant stability to be more readily attained
-same adv as type 2

Question 5

success of early implant compared to immediate or delayed

Answer 5

Bassir 2019:
No difference in risk of implant failure between the early and immediate or delayed
sig less MBL with early placement protocol compared to immediate

Chen and Buser 2014: survival rates are similar
Type 1 has greater variability in esthetic outcomes and a higher frequency of recession of > 1 mm of the midfacial mucosa compared to early (type 2 and type 3) implant placement
Type 1 with bone graft has no detectable bone on CBCT in 36% and 57% of sites. These sites had more recession compared to sites with detectable facial bone.
Type 2 and 3 placement demonstrated a high frequency (above 90%) of facial bone wall visible on CBCT.

Question 6

type I indications

Answer 6

-intact facial bone wall >1mm thick
-thick phenotype
-no acute infection
-sufficient volume of bone apical and palatal for correct 3D positioning and sufficient primary stability

Question 7

Indications for type 2 placement:

Answer 7

-thin or damaged facial bone wall
-sufficient bone volume apical and palatal for good stability and ideal prosthetic placement

Question 8

Indications for type 3 placement:

Answer 8

large periapical lesions, remove lesion allow for healing, then do implant w GBR (same as type 2 but just wait longer for healing)