Immediate Implants in extraction sockets with periapical lesions: A Prospective study

Immediate implant placement of dental implants into fresh extraction sockets was shown to be a predictable and successful procedure when proper protocols were followed. Immediate implant placement into infected sockets has resulted in variable success rates. To date results from published studies are incon­clusive and unclear as to whether immediate implant placement into sites with periapical infec­tion increases the risk of implant failure or successful osseointegration. This study aims to evaluate the efficacy of immediate implants placement in fresh extracted sockets with peri-apical lesions as compared to without peri-apical lesions. This Prospective controlled trial will consist of a Control Group with patients with 12 extraction socket without peri-apical infection and study Group of patients with 12 extraction sockets with peri-apical infection. All patients will follow a pre-operative regimen of 0.12% chlorhexidine mouthwashes and 625 mg amoxicillin/clavulanic acid. In the study group after traumatically extracting the tooth with peri-apical pathology, the alveolae will undergo meticulous curettage in all socket walls to remove all the granulation tissue and will be disinfected. Osteotomy will be prepared on the palatal side by sequential drilling protocol according to the implant size indicated by the implant manufacturer, by Adin. After sequential drilling, the implant placement will be done achieving insertion torque

35 N/ cm in all cases and cover screw will be placed. All cases will be followed up after 1 week and at 4 months. At week 1 of follow up VAS score will be used to assess for pain. Implant survival, Implant Stability Quotient (ISQ) by RFA and Labial bone thickness at the baseline and at 4 months of follow up will be assessed.