Post extraction immediate implant placement in infected extraction sockets of maxillary posterior teeth combined with guided bone regeneration. Two-years prospective clinical and radiographic outcomes

Aim: This study aimed to evaluate clinical and radiographic outcomes of immediate implant placement in infected extraction
sockets of maxillary posterior teeth (presented with buccal fenestrations) combined with guided bone regeneration.
Materials and Methods: Eight patients with non-restorable maxillary posterior teeth that needed to be extracted due to failure
of endodontic treatment or badly destructed teeth presented with periapical lesions and buccal fenestrations were included for
this study. Implants were immediately inserted in extraction sockets after adequate debridement, curettage, and irrigation,then
the gap between the implants and sockets were filled with bone graft and guided bone regeneration.Clinical (plaque scores,
gingival scores, probing depth, and width of keratinized mucosa) and radiographic (crestal bone loss) outcomes were evaluated
at baseline (prosthesis insertion), 6, 12 and 24 months later.
Results: A total of 21 implants were placed in 8 patients.Three implants failed resulting in 95 % cumulative survival rate
after 24 months. Plaque scores significantly increased from prosthesis insertion to 6 months then significantly increased from
six months to 12 months.Gingival scores increased significantly from baseline to 6 months, then decreased significantly at
12 months. Pocket depth increased from prosthesis insertion to 6 months, then significantly decreased from 12 months to 24
months. No significant difference in keratinized mucosal width between different time intervals. Crestal bone loss significantly
increased from 6 months to12 months, then significantly increased from 12 months to 24 months.
Conclusion: Within the scope of this investigation, post extraction immediate implant insertion in infected sockets of maxillary
posterior teeth presented with bone defects or buccal fenestrations and bone augmentation is a safe and predictable method as
implants demonstrated good clinical and radiographic outcomes after 2 years.