List of Contributors ix
Foreword xvii
Preface xviii
Acknowledgments xix
1 Introduction, History and General Principles 1
Douglas Deporter, Domenico Baldi, and Mohammad Ketabi
Background 1
The Timing of Implant Placement 1
Early Work with Immediate Implant Placement 6
Biological Benefits of "Immediacy" 7
Indications for Immediate Implant Placement in Anterior and Premolar Sites 8
Impact of Socket Configuration on Immediate Implant Placements 14
Accepted Ways of Minimizing Peri-Implant Crestal Bone Loss with Immediate Implant Placements 16
Conclusions 17
References 17
2 Radiographic and Anatomic Considerations 25
Venessa Mendes and Trevor Thang
Introduction 25
Imaging Techniques 25
Cone Beam Computed Tomography 25
Radiographic Evaluation for Immediate Implant Placement 26
General Osseous Considerations 26
Alveolar Bone Thickness 26
Variations in Trabecular Bone Density 26
Nasopalatine Canal and Foramen 27
Middle Superior Alveolar Canals 29
Nasal and Maxillary Sinus Floors 30
Mental Foramen 30
Anterior Loop of the Inferior Alveolar Nerve 31
Mandibular Incisive Canal 31
Lingual Foramina 34
Tooth-Related Complications 34
Mandibular Canine Bifurcations 34
Conclusions 35
References 36
3.1 Immediate Implant Placement in the Maxillary Esthetic Zone 39
Henny J.A. Meijer, Vincent J.J. Donker, and Gerry M. Raghoebar
Introduction 39
Preoperative Screening 40
Implant Surgery in General 40
Immediate Implant Treatment in Combination with Immediate Provisionalization 40
Assessment 40
Diagnosis and Planning Procedures 40
Surgical Procedures 40
Prosthetic Procedures 41
Follow-up 41
Case Presentation One 41
Case Presentation Two 41
Case Presentation Three 48
Case Presentation Four 51
Discussion 53
Conclusions 54
References 54
3.2 Immediate Maxillary Premolar Implant Placement 56
Mehdi Valizadeh, Antonio Barone, Rossana Izzetti, Chiara Cinquini, and Celine Soon
Introduction 56
Sagittal Root Position and Bone Angulation 56
Maxillary Sinus Proximity 57
Case Selection 61
Intact Versus Non-Intact Socket 61
Suggested Surgical Protocols 61
Extraction 61
Attaining Bone Anchorage 61
Implant Selection 63
Soft Tissue Modification 65
Discussion 69
References 69
3.3 Challenges in Placing Multiple Immediate Implants in Anterior Maxilla 72
Douglas Deporter, Mohammad Ketabi, Richard Martin, and Ehsan Birang
Introduction 72
Case Selection 74
Further Sample Cases 76
Conclusions 81
References 81
4 Immediate Implant Placement in Mandibular Anterior and Premolar Sites 83
Stuart Froum, Deporter Douglas, Dai Lao Rodriguez, Mohammad Ketabi, and Benedetta Grassi
Introduction 83
Sample Cases 86
Case One 86
Sample Case Two 86
Conclusions 94
References 94
5.1 Minimally Invasive Guided Bone Regeneration Techniques for Hard and Soft Tissue Augmentation with Simultaneous Immediate Implant Placement 97
Mehrdad Lotfazar
Introduction 97
Tunneling 97
Intrasocket Guided Bone Regeneration 98
The Ice Cream Cone Technique 105
Conclusion 113
References 117
5.2 Immediate Implants Needing Traditional Guided Bone Regeneration 119
Douglas Deporter, Amir Moeintaghavi, and Mohammad Ketabi
Introduction 119
Sample Cases 119
Case One 119
Case Two 122
Case Three 122
Discussion 122
References 128
5.3 Immediate Implant Placement in Compromised Maxillary Anterior and Bicuspid Sites: Immediate Dentoalveolar Restoration with Osseodensification 129
Jose Carlos Martins da Rosa
Introduction 129
Immediate Dentoalveolar Restoration Technique 129
Case Selection 132
Discussion 133
Conclusions 139
References 139
5.4 Aesthetic Reconstruction of Severely Resorbed Alveolar Bone with Immediacy using Tenting Healing Abutments or Tooth Bone "Rings" 141
Dong-Seok Sohn
Introduction 141
Background 141
Autogenous Block Bone Grafting 141
Intraoral Distraction Osteogenesis 141
Sandwich Augmenting with Interpositional Bone Grafting 141
Split Bone Block Technique 142
Guided Bone Regeneration (GBR) 142
Soft Tissue Matrix Expansion Technique Using A Tenting Pole Technique 142
The Vertical Tenting Pole Abutment 142
Description of the Sohn Bone Builder Tenting Pole Approach 143
Using Vertical Tenting Pole Healing Abutments in a Maxillary Anterior Site 143
Case One 143
Case Two 146
Vertical Bone Regeneration Around Immediate Implants Using Demineralized Tooth "Rings" 152
Discussion 164
Conclusion 164
References 165
6 Soft Tissue Grafting with Immediate Implant Placement 169
Neda Moslemi and Mohammad Reza Talebi
Introduction 169
Evolution of Soft Tissue Grafting during Immediate Implant Placement 169
To Preserve/Improve Buccal Contour Convexity 170
To Prevent Peri-Implant Soft Tissue Dehiscence/Deficiency 171
To Preserve/Improve Interproximal Papilla Thickness/Height 171
To Minimize the Need for Buccal Flap Advancement 171
Should Soft Tissue Grafting be Considered as the Standard of Care in Esthetic Immediate Implant Placement? 172
Surgical Techniques for Soft Tissue Grafting 172
Scarf-Connective Tissue Graft 172
Scarf-Connective Tissue Graft versus Coronally Advanced Flap/Tunnel Technique plus Connective Tissue Graft 172
Tunnel Technique plus Connective Tissue Graft 172
Coronally Advanced Flap plus Connective Tissue Graft 179
When to Select Coronally Advanced Flap plus Connective Tissue Graft or Tunnel Technique plus Connective Tissue Graft? 179
Rotated Pedicle Palatal Flap (RPPF) 179
Why Perform Soft Tissue Grafting and Immediate Implant Placement in the Same Surgery? 186
How Stable Are the Results of Soft Tissue Grafting? 186
Conclusion 193
References 193
7 Anatomically Guided Immediate Implant Placement in Maxillary Anterior and BicuspidSites 197
Deporter Douglas, Quang Nguyen, and Mohammad Ketabi
Introduction 197
The Concept of Anatomically Guided Implant Placement 197
Discussion and Conclusions 204
References 210
8 Guided Surgery for Placing Immediate Implants using Standard Osteotomy Preparation or Osseodensification 213
Arndt Guentsch
Introduction 213
Digital Workflows in Implant Dentistry 213
Data Acquisition 214
Intraoral Surface Scan (IOS) 215
Virtual Treatment Planning 215
Data Manipulation 215
Registration of Cone Beam Computed Tomography and Intraoral Surface Scan 216
Virtual Tooth Extraction 216
Wax-up 220
Three-Dimensional Implant Positioning 220
Guide Design 222
Sleeve Selection 222
Basic Design Principles 222
Workflow for Guide Design 223
Guide Production 226
Guided Implant Surgery 227
Immediate Implant Placement with Customized Provisional or Healing Abutment 229
Immediate Implant Placement with Guided Osseodensification 230
Conclusions 239
References 239
9 Optimizing Immediate Loading with Immediate Implants 245
Adriano Piattelli, Luca Comuzzi, Alessandro Cipollina, Tea Romasco, Giulia Marchioli, Natalia Di Pietro, and Amirhossein Majidi
Introduction 245
History of Immediately Loaded Implants 245
Microstructure of Bone under Loading 246
Immediate Loading of Immediate Implants 247
Biconometric Concept and Navigated Surgery 247
Use of Dynamic Navigation for Immediate Functional-Loaded Immediate Implant Placement 254
Pre- and Immediate Postoperative Use of a Zinc-L-Carnosine Mouthwash 255
Use of Complex Magnetic Fields during Healing of Immediate Functional Loaded Immediate Implant Placements 260
Conclusions 261
References 262
10 Emergence Profile Following Immediate Implant Placement in the Esthetic Zone 265
Edwin Ruales-Carrera, Patricia Pauletto, Lenin Proano, and Jose Luis Viteri
Introduction 265
Implant Selection and its Relation to the Emergence Profile 265
Implant Placement in the Esthetic Zone 266
The Emergence Profile Contours 266
Timing of Implant Placement and its Relation to Emergence Profile 267
Prosthetic Modification of the Emergence Profile 268
Transfer of the Emergence Profile 269
Restorative Materials and their Relation to the Emergence Profile 269
Conclusions 273
References 273
11 Immediate Implant Placement in Infected Tooth Sockets 275
Mahdi Kadkhodazadeh, Anahita Moscowchi, and Reza Amid
Introduction 275
Treatment Steps 280
Extraction of Infected Teeth 280
Complete Debridement of Tooth Extraction Sockets 280
Platelet Concentrations in Infected Site Implantation 280
Are Systemic Antibiotics Needed? 280
Assessment of Treatment Success 284
Complications 284
Conclusions 284
References 287
12 Angled Implant Design (Dual Axis Implants) in Immediate Implant Placement in the Anterior Maxilla 289
Mehdi Valizadeh, Dale Howes, Petros Yuvanoglu, Costa Nicolopoulos, and Stephen Chu
Introduction 289
Anatomy of Teeth, Alveolar Bone, and Sagittal Root Position 289
Apical Socket Perforation Rate 290
Cement-Retention Versus Screw-Retention and the Issue of Buccally Inclined Implants 291
Angle-Correcting Abutments and Angled Screw Channels 291
Subcrestal Angle Correction: Development of a Root Form Dual Axis Implant 292
Screw Loosening 295
Variable Platform Switching 299
Macro Hybrid Subcrestal Angle Correction Implant (Body Shift Concept) 299
Conclusions 300
References 304
13 Complications with Immediacy and their Management 309
Stuart Froum, Douglas Deporter, Nasrin Esfahanizadeh, Mohammad Ketabi, and Chih Hao Shyu
Introduction 309
Potential Complications 310
Excessive Bleeding 310
Buccal or Lingual Plate Perforations 310
Implant Misalignments and Malpositioning 311
Damage to Vital Structures 315
Esthetic and Soft Tissue Complications 318
Post-Treatment Infection 318
Conclusions 323
References 323
Index 327
