Immediate placement of dental implants into debrided infected dentoalveolar sockets

Purpose: To describe a protocol for the immediate placement of endosseous implants into debrided infected dentoalveolar sockets. Patients and Methods: A total of 30 implants were immediately placed into debrided infected sites in 20 patients. The pathology at the receptacle dentoalveolar sockets varied, and included subacute periodontal infection, perio-endo infection, chronic periodontal infection, chronic periapical lesion, and a periodontal cyst. The immediate placement protocol emphasized the meticulous debridement of the infected tissues in combination with peripheral ostectomy of the alveoli. Guided bone regeneration was accomplished to support bony heating of alveolar defects surrounding the implantation site. Pre- and postsurgical antibiotic therapy was administered. Results: All implants but 1 were osseointegrated and functional when followed up after 12 to 72 months. One implant was mobile after its immediate restoration and was removed. Complications were related to the use of guided bone regeneration. Deficiency of the attached gingiva was noted in 1 case. The treatment approach is illustrated in 2 anterior maxilla cases with 3-year follow-up. Conclusions: Successful immediate implantation in debrided infected alveoli depends on the complete removal of all contaminated tissue and the controlled regeneration of the alveolar defect. With this proposed clinical approach, experienced clinicians may consider immediate implants as a viable treatment option in patients presenting with dentoalveolar infections. (C) 2007 American Association of Oral and Maxillofacial Surgeons.