Scientifica implantology

Journal of Clinical Periodontology, 2012 Jun; 39: 582-589

Considering the great attention devoted by researchers in recent years to the use of post-extraction implants and to the consequent advanced recession of
vestibular tissues, the prestigious Journal of Clinical Periodontology published a systematic review of the topic. The review concludes that there is a lower risk
of recession if the residual post-extraction vestibular bone wall is intact, the gingival biotype is thick, and if a very conservative flapless surgical procedure can be performed. When these parameters are not present, it is advisable to make a careful assessment of the aesthetic risks that may be encountered.

Medicina Oral Patología Oral y Cirugía Bucal, 2012; 17: 251-261

This systematic review of the use of immediate post-extraction implants included 20 studies, 3 of which were conducted with Global and Outlink² implants, confirming the excellent quality of the work of researchers who use Sweden & Martina implants. The review concludes that the results of postextraction implants are comparable to those of delayed implants, save for the possible onset of complications, particularly if the jumping distance, that is the gap between bone and implant, is greater than 1 mm or in the presence of bone defects.

Clinical Oral Implants Research, 2012; 23 (Suppl 5): 39-66

This extensive systematic review of the outcome of immediate post-extraction implants was drawn up during the 6th Expert Meeting of Osteology, with the title Evidence-based Knowledge on Biology and Treatment of Extraction Sockets Including the Placement of Dental Implants. Of the 46 works included in the review, 9 concerned the use of Sweden & Martina implants, which are therefore rated amongst the most highly referenced worldwide. According to the review, the studies included all demonstrate that the survival rate of post-extraction implants is high, while in other studies the results are sometimes not in agreement as regards the success parameters (stability and maintenance of peri-implant tissues). Further studies are therefore necessary to investigate these aspects.

The International Journal of Periodontics & Restorative Dentistry, 2012; 32: 29-37

20 immediate post-extraction implants were inserted in 15 patients with a flapless technique and immediately loaded with temporary prostheses. The implants were followed for a period of 24 months, at the end of which the survival rate was 100%, the marginal gingival level had decreased by 0.22 ±0.15 mm in the first months and then remained unvaried until 24 months. Bone reabsorption at 24 months was 0.83 ± 0.52 mm. The flapless technique is therefore able to preserve soft and hard tissues.

Clinical Oral Implant Research, Early View, First Published online on 2012, January, 6th

This prospective study monitored the behaviour of gingival fenestration around immediate rehabilitations of total edentulism for three months after operation. The variations of the mean buccal height and of the inter-proximal papillae were measured. The mean variation of the buccal height was 0±0.76 mm, the mesial point lost 0.035±1 mm, the distal point 0.05±0.92 mm. The researchers considered these data positive, but further study is needed.

Journal of Periodontology, 2012; 83: 1226-1234

This study sums up the outcome at 10 years of 159 immediate post-extraction implants in 91 patients, with a mean cumulative success rate of 91.8%. In 101 of these implants, inserted coinciding with GBR, at 10 years the survival rate rose to 94.1%. The clinical attachment level and the marginal bone level remained substantially stable for the whole ten-year period.

Clinical Oral Implant Research, 2013; 24: 50-56

In the vestibular portion of immediate post-extraction implants, a graft of connective tissue obtained from the palate was positioned in vivo to test their capacity to preserve hard tissues (Test Group). At 4 months, bone reabsorption did not show any significant differences, with respect to the Control Group in which the graft had not been positioned, but there was a greater amount of mucous tissue in the Test Group. Clinically it is therefore useful to use a connective graft when there is a high aesthetic expectation.

The surgical procedures for positioning implants immediately after tooth extraction were described for the fi rst time by Professor Schulte of the University of
Tubingen. This surgical implant technique subsequently became increasingly more popular and was described in association with Guided Bone Regeneration (GBR) techniques.
Our research team guided by Prof. Covani has always been actively involved in conducting research in this field; it should be noted that in 1999 we personally received from Prof. Schulte an award at the international symposium of Bonn reporting some observations on the horizontal remodelling of the alveolar bone around post-extraction implants. In 2003, these early observations were worthy of international publication, in particular those relating to horizontal and vertical bone reabsorption around the post-extraction implants. Once again, our team anticipated the intuitions of many other authors with a publication in 2004 showing that the aesthetic and clinical results are better in cases where a “fl apless” technique was used.
In the same year, the team, which also included the late unforgettable Roberto Cornelini, published the fi rst longitudinal study at 4 years on implants positioned at the same time as the dental extraction, reporting extremely interesting results (a 97% success rate). But the research, often associated to the use of Premium implants, evolves even further when examining the technique that calls for positioning implants in post-extraction sockets and their immediate prosthetization.
Swiss research teams later analysed the effi ciency of post-extraction implants in animal models finding extremely negative results on bone reabsorption. These observations caused scientists to re-examine the technique relating to post-extraction implants, but once again, with recent studies, our team was able to demonstrate that correct positioning of the implant, possibly associated to the use of regenerative techniques, can prevent bone reabsorption around post-extraction implants and result in the possible recover.
In presenting the review of the articles on the theme of immediate implants, we are proud to say that the Premium implant, in the specifi c application, has earned full scientifi c and clinical dignity as the most accredited implant systems.

Journal of Periodontology, 74(2):268-73, 2003

In this study, the extraction surgical protocol with immediate implants in single-rooted sockets with differed loading at 6 months has shown favourable and predictable results.

Implantologia Orale, 5 (11): 37-40; 2004

MARGINAL BONE HEALING IN IMMEDIATE POST-EXTRACTION SITES

Premium implants used in post-extraction situations also provided excellent results in the presence of marginal bone defects.