Open AccessEarly Osteotomy With Delayed Implant Placement: A Step Further for Immediate Loading
Author(s) -
M S El Attar,
Hazem H Mourad,
Aly Mahmoud,
M.G. Abdallah,
Hussien Garana,
Khaled M Mansour,
Mohamed Fata
Publication year - 2006
Publication title -
implant dentistry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.538
H-Index - 65
eISSN - 1538-2982
pISSN - 1056-6163
DOI - 10.1097/01.id.0000202427.15792.17
Subject(s) - osteotomy , medicine , implant , osseointegration , soft tissue , abutment , surgery , dentistry , civil engineering , engineering
The commonly used implantation technique involves a 2-stage surgical protocol for load-free and submerged healing to ensure predictable osseointegration. This article presents a new approach that benefits from previous bone and soft tissue protocols. It combines new surgical and insertion techniques to perform immediate loading with delayed implant placement, avoiding the problems of discomfort, inconvenience, and anxiety associated with healing periods. It maintains a similar success rate to the present common technique. After osteotomy, bone healing passes through 3 stages (i.e., inflammation, fibrous tissue, and maturation). In the new approach, implant insertion is performed 2 weeks after drilling (i.e., during the fibrous phase). The insertion timing is so selected because collagen formation and revascularization represent an acceptable implant bed configuration. Flap surgery offers the optimal osteotomy approach, but esthetic outcomes are definitely compromised. Accordingly, adopting the punch technique alleviates several postoperative problems, such as pain, tenderness, and swelling. Moreover, the punch technique avoids the sutures needed to adjust the gingiva around the abutment. It provides both cosmetic and functional properties.