Early placement of implant with novabone morsels: will this work?

I placed a 5 x 8.5mm Osstem TS III SA one week after extraction in the mandibular first molar site. Final torque of 45N was achieved. Lingual wall was intact, but buccal wall was deficient by 2mm. Surgical site was packed with NovaBone Morsels mixed with patient’s blood. A collagen membrane was used to cover the graft site and primary closure was achieved. Do you think this procedure will be successful?


9 Comments on Early placement of implant with novabone morsels: will this work?

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Sb oms
4/6/2016
Even if this does work, look how deep the shoulder of this implant is compared to the adjacent teeth. I think this is creating a problem for the patient. Yes it's nice to do immediate implants, but would you want this in your mouth? You should have grafted and waited for some healing before doing the implant. My criteria for immediate molar implants is just this concept- how deep do I have to place it to get good bone-implant contact? Obviously in this case, the answer was too deep.
Dr
4/6/2016
Would a longer implant here helped the area? Yes the depth of the implant will pose a prosthetic problem!
F Campos
4/6/2016
It is tue that patients like to have their teeth yesterday. I walked away from immediate placement A few years back. rather do socket preservation and repair site if necessary and wait 3 or 4 months believe me it would be more predictable at the end. it looks that have you done socket preservation quite possible to get a 11.5 implant in that site later on. Did you buried the implant on bone graft material? Also it's seems that the 8.5 mm implant is less than 50% threaded in bone. Hope everything comes ok. If you want to play safe remove/ graft-repair site and replace implant with a more suitable size. Like the first comment if you restore this implant as is implant/ crown ratio is off. good luck
Jawdoc
4/7/2016
It would have been great if uve used a 13mm length. Or @ least 11.5mm. Having said that, all is not lost. Crestal resorption does take place & Osstem implants osseointegrate very well so crown height to implant length ratio can be way more than 1:1, if occlusion precaution is taken into account. Next time, socket graft it 1st & then wait for 3-4 months @ least (as it's a 4-wall defect) before putting in implant. Thanks for sharing. Interesting case.
CRS
4/10/2016
I'm sorry but this X-ray shows no understanding of restoratively driven implant placement. The short implant has been placed in a deep crater either the area will not heal or the bone will heal over the implant.In any case it is not a restorable implant.Please post the result. While my colleagues have posted more tactful comments sometimes I feel it is more beneficial to state what I feel is the truth. Remove it build up the buccal plate and graft the defect. Then place an implant which is restorable at the crest of the ridge and in harmony with the adjacent teeth. Even a longer implant emerging thru the graft with primary closure would have been preferable. Graft material is not a magic fix when the placement is incorrect.
Not recognised dentist
4/10/2016
It always interesting to read your comments; and as always I agree with it (almost :) ). And i will post my cases , cause interesting to here your opinion...(I did some experiments...) P.S.: to all others colleagues : you are also professionals... and appreciate your opinions too!!!
CRS
4/10/2016
It would also be helpful to see what the pre extraction X-ray looked like since you state this is a one week placement. I don't see any evidence of the original root morphology in the bone. I suspect there was some significant pathology to cause that much bone destruction or the bone was lost on tooth removal. A more complete picture would be helpful if you would like to learn more. It is difficult to build a house on a poor foundation. And to answer the original question I do not think this will be successful in integration, restoration or long term maintenance. Thanks for posting and trying to learn.
Gregori Kurtzman, DDS, MA
4/12/2016
I would agree with the comments the implant will integrate BUT its very deep and will be prosthetic issues restoring and long term due to the depth. A longer implant should have been used bringing the platform to the same level as the adjacent tooths cervical at the crestal bone level
Justin
4/13/2016
Depends on what you consider success. I think it will integrate but be very challenging to restore, if even possible. How will you get access to restore the implant if 3-4 mm bone heals over the top? Thanks for posting.

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