THE WAYS AND WHEREFORES OF IMMEDIATE PLACEMENT OF IMPLANTS INTO FRESHEXTRACTION SITES - A LITERATURE-REVIEW

A WAITING PERIOD OF 12 MONTHS or longer to allow total socket healing used to be accepted protocol for placing dental implants. More than 15 years of research and clinical practice were needed for the concept o f immediate endosseous implantation into fresh extraction sites to be accepted. Today the dilemma is no longer when, but which, protocol to follow. The diverse recommendations found in the literature leave the practitioner confused as to the methodology of choice. The conclusions drawn after reviewing the relevant literature on immediate dental imp lantation are: 1) implants placed into fresh extraction sockets have a high rate of survival, ranging between 93.9% to 100%; 2) implants mus t be placed 3 to 5 mm beyond the apex in order to gain a maximal degre e of stability; 3) implants should be placed as close as possible to t he alveolar crest level (0 to 3 mm); 4) there is no consensus regardin g the need for gap filling and the best grafting material; 5) the use of membrane does not imply better results-on the contrary, membrane ex posure may carry complications in its wake; and 6) the absolute need f or primary closure remains to be established.