Immediate placement: Feedback to minimize complications?

Last Updated September 18, 2015
Reviewed By:  Dr. Peter Hunt

I have had a couple of post-op complications with extraction of posterior lower molar followed by immediate implant placement, and would appreciate any feedback on how to minimize these complications from occurring again.

I have a healthy 35-year old patient and I extracted #30 [mandibular left first molar] and immediately installed an implant in the mesial extraction socket. I achieved primary stability. I placed bone graft in the distal socket and around the implant. I was not able to obtain primary closure even after releasing incisions and flap(very large molar). So, I placed resorbable membrane over bone graft and implant, followed by cytoplast non resorbable membrane draped over entire crestal area. Probably overkill, but worried about oral cavity exposure and bacteremia or worse.

One week later the patient complained of a dull, throbbing pain in the area, that persisted followed by mild inflammation. I removed the membrane, irrigated with chlorhexidine and prescribed amoxicillin 500mg. After one week, the pain resolved. Any recommendations on how I could improve my technique and my results for cases like this?

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