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……


Leave a Comment:

Comment Guidelines: Be Yourself. Be Respectful. Add Value. For more details, read our comment guidelines. Though we require an email to comment, we will NEVER publish your email.
Required fields are marked *

Posted in Immediate Loading, Planning & Complications.
Bookmark Immediate Insertion for Teeth with Periapical Infections?

Videos to Watch:

Dealing with the Implant Gap

This short video discusses how to best deal with the gap after immediate implant insertion[...]

1 Comment

Watch Now!
Lower Right Molar Extraction & Immediate Implant Placement Using i-PRF

In this video, the lower right second molar was extracted and grafted with i-PRF and[...]


Watch Now!
Maxillary Implantation with Treatment of Chronic Sinusitis

This video shows two cases where implants were placed following treatment of Sinusitis. [...]


Watch Now!
Suturing in Guided Bone Regeneration

This video provides clinical tips for suturing techniques in Guided Bone Regeneration. In Guided Bone[...]

1 Comment

Watch Now!
Socket grafting with Collagen Dressing and Bond Apatite

This video demonstrates socket grafting with just bond apatite and a collagen wound dressing.[...]

Watch Now!
Dental Implant for Lower Right Second Molar

This video shows implant placement on the lower right second molar.[...]

Watch Now!
Saving a Bridge with Periodontal Therapy

This video shows a case involving a 48-year-old male who was referred for periodontal treatment[...]

Watch Now!
Immediate Loading Full Arch

This video shows a case of Immediate loading of a full arch with simultaneous guided[...]

Watch Now!
Apically Repositioned Flap Technique Around Implants

The apically positioned flap is a commonly used surgical approach, that may help the long[...]

Watch Now!
Digitally Planned Bone Augmentation and Immediate Implantation

This video shows a case using the Ring technique to provide bone augmentation along with[...]

Watch Now!
AnyRidge Implants: Replacement of Upper Left Molars

This video shows the replacement of maxillary upper left molars with Megagen AnyRidge Implants.[...]

1 Comment

Watch Now!
Guided Implant Surgery & Immediate Temporisation

This video demonstrates the placement of a missing pre-molar using computer-guided surgery and immediate temporization.[...]

1 Comment

Watch Now!