Immediate placement of implants in extraction sites of maxillary impacted canines

Background. Treatment of asymptomatic : impacted maxillary canines in adult s is inevitable when primary canine becomes lost through extraction or exfo liation or when the impacted tooth becomes symptomatic. Treatment alternati ves include an orthodontic procedure to bring the unerupted tooth to the de ntal arch or prosthetic replacement of the missing tooth. The authors descr ibe an alternative treatment that involves immediate placement of implants into extraction sockets of the teeth. Case Description. A patient with bilateral palatally impacted upper canines chose to have the unerupted teeth removed and replaced with implants and c rowns. Two hydroxyapatite cylindrical implants were inserted through the al veolar ridge into the extraction sites. The unfilled areas in the extractio n sites, around the dental implants, were packed and covered with demineral ized freeze-dried:bone allograft in conjunction with a collagen membrane ba rrier. Six months after implantation, computed tomography revealed complete osseous fill of the extraction defects and no bone loss around the implant s; The implants were uncovered, and porcelain-fused-to-metal restorations w ere fabricated and placed. Clinical Implications. This treatment modality avoids the need for conventi onal preparation of teeth as part of prosthetic reconstruction or prolonged orthodontic treatment aimed at bringing the impacted canine to the dental arch. Combining the implantation with bone augmentation preserved the alveo lar bone and shortened the treatment period.