Post-extractive implantology is a special dental technique that involves the insertion of dental implants immediately after tooth extraction.
The dentist proceeds to the extraction of the tooth only if it is indispensable, the priority of dentistry in fact is to preserve the natural teeth in any clinical case in which it is feasible.
The extracted tooth is infected: repercussions on post-extractive implantology
The conditions for which a natural tooth is extracted are:
- fracture;
- necrosis;
- acute infection.
In the latter case it is very important to evaluate the conditions of the implant site after tooth extraction.
If the infection of the tooth has infected the surrounding tissues or the socket could create the conditions for an infection in the dental implant that will be inserted later, post extraction implantology is generally not recommended.
In particular, it could happen that the presence of a periapical lesion in the part where the tooth has been extracted may have repercussions on post-extractive implantology.
Cases of implant failure in implantology
Studies were conducted on implantology performed following the extraction of a tooth to verify the success rate of the intervention and in which cases the presence of an infection led to implant failure.
The results of recent research have been published in the Journal of Endodontics. The researchers analyzed the clinical cases of 596 Swedish patients for a total of 2367 implants placed at different time periods.
The 596 patients were divided according to the clinical causes that led to tooth extraction:
- periodontitis;
- caries;
- root fracture;
- trauma;
- set of multiple causes.
To this parameter they added another variable, namely the time elapsed between tooth extraction and post extraction implantology:
- implantology less than 7 days after the extraction;
- implantology in the 1-7 weeks after extraction;
- implantology between 16-51 weeks after the extraction;
- implantology 52 weeks after extraction.
The clinical conditions were also recorded in the various phases of intervention:
- tooth health at the time of extraction;
- patients undergoing antibiotic therapy;
- implant failure;
- implant failure due to peri-implantitis.
Results
Deep caries was the first cause of tooth extraction, a fact that emerged in 64% of the clinical cases analyzed. Of this percentage, 51% of patients had already undergone root canal therapy for the treatment of caries.
The success rate was over 95% and the cases of implant failure occurred following infections.
The presence of infections immediately after the placement of the implants has considerably compromised the possibility of success; infections occurring after some time have led to a lower percentage of implant loss.
In the presence of periapical lesions it was impossible to proceed with post-extractive implantology.
To avoid an implant failure or implant loss it is important not to neglect the preliminary phase of the intervention, ie the patient’s clinical history and implant planning based on specific needs.
