Immediate Insertion for Teeth with Periapical Infections?

Joel, a dentist from Rochester, asks:
I am doing an immediate insertion maxillary complete denture after extracting several non-restorable teeth with periapical infections.

After the infections have resolved and the areas have healed, I am
going to place 4 dental implants in #4, 6, 11, 13 areas to support a maxillary
overdenture. My protocol is to extract the teeth, allow infections to
resolve and then place dental implants.

My patient requested that I remove the teeth and place the dental implants at
that time. His neighbor had this done and he only wants one surgical
procedure, not two.

Have any of you attempted this immediate load procedure where there are clear signs clinically and radiographically of periapical infection?

6 thoughts on “Immediate Insertion for Teeth with Periapical Infections?

  1. Joseph Kim, DDS says:

    You can do it depending on the size and type of periapical pathology, but you will experience some increased failure rate. Make sure you thoroughly currette the socket and debride the lesions. I use a surgical round bur to get back to “clean” bone. Ideally, you would like to eliminate the entire pathology with your osteotomy.

  2. Dr.Hajiheshmati says:

    Dear Dr.Loel
    It is possible to do successful dental implant in extracted and infected socket if you could completely remove the infection by courette and Lazer,and have find a primary stability in the area,if you havenot lazer you could not completely remove the infection so if the pathogens overgrowth and break the defence mechanism they could damage the osseointegrated fixture,and the fixture become loose soonly.

  3. Anonymous says:

    My question is this: who pays for your time/matl’s to re-tx if you have a failure; and if there is a problem, are you guarenteed not to be sued?
    When you push the envelope, you are flying in rarefied air, and you can drop quickly.

  4. J. Routsong DDS says:

    I feel that it is important to get rid of the infection before placing the implants.
    Its important to debride the sockets with a curette and perhaps some disinfection could be
    achieved with a low watt laser. But Then you could place the implants immediately. However, I would not immediately load them. I think that is just too much to ask. These patients want results but they have to realize that placing implants takes time. I feel its good to wait for osseointegration before loading, in this case where periapical infection is existent in the osteotomy sites.

  5. J.R. DDS says:

    the idel however, is that you would extract the tooth and debride the socket. and then wait 3-4 weeks for healing then you could graft and place the implant.

  6. Albert Hall says:

    Dear Doctor, is not the neighbor or the rep who tells you what to do….Cardiosurgery patients should stay at the clinic for weeks before they have been released…..

    In dentistry everything should be quick and fast….but patients need a lot, a lot of information of biology and their bodies……

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