A case of digitally assisted immediate implant placement through impacted teeth in the aesthetic area

doi:10.12337/zgkqzzxzz.2024.06.012

Abstract

Abstract: This paper presents a case of digitally assisted immediate implantation through impacted teeth in the aesthetic area. The patient had a root fracture caused by an upper anterior teeth trauma. One impacted canine and two impacted supernumerary teeth were found in the bone on the root side of the affected teeth. During treatment, under the guidance of the digital surgical guide plate and assistance by Er : YAG laser, immediate implantation through the impacted teeth was achieved. At the same time, autologous bone grafting material and platelet-rich fibrin were mixed for bone grafting at the two implant sites. Provisional and permanent restorations were completed with digital technology at 5 months and 8 months after the first stage of surgery, respectively. Postoperative CBCT showed that the implants penetrated through the crown, apical cementum, dentin, and pulp of the impacted teeth. No pain or other complications were found during the follow-up visit. There were no clinical symptoms at the 18-month follow-up visit. CBCT images showed that the bone density around the implants had increased and the lamina dura had formed. In this case, immediate implantation through the impacted teeth in the aesthetic area was realized with the digital assistance, providing a new clinical idea for the selection of treatment options for impacted teeth and increased clinical data for other healing forms of implants besides osseointegration. However, the clinical effect of this kind of operation still needs long-term follow-up observation.

Key words: Immediate implant placement, Impacted teeth, Laser, Digitalization

Zhao Ning, Li Xiaojie, Kou Ni, Ma Guowu. A case of digitally assisted immediate implant placement through impacted teeth in the aesthetic area[J]. Chinese Journal of Oral Implantology, 2024, 29(3): 266-271.

References

[1] Frank CA.Treatment options for impacted teeth[J]. J Am Dent Assoc, 2000,131(5):623-632.DOI: 10.14219/jada.archive.2000.0236.
[2] Amato F, Macca U, Amato G, et al.Immediate loading of implants inserted through im-pacted teeth in the esthetic area: a series of 10 cases with up to 7 years of follow-up[J]. Int J Periodontics Restorative Dent, 2019,39(3):325-332. DOI: 10.11607/prd.3978.
[3] Pérez-González F, Sánchez-Labrador L, Mo-linero-Mourelle P, et al. Dental implant placement through impacted teeth or residu-al roots as an alternative to invasive extrac-tion surgeries: a systematic literature re-view[J]. Br J Oral Maxillofac Surg, 2021,59(10):1120-1129. DOI: 10.1016/j.bjoms.2020.12.018.
[4] Mithridade D, Serge SM, Keyvan D, et al.Unconventional implant placement IV. Im-plant placement through impacted teeth to avoid invasive surgery. Long-term results of 3 cases[J]. Open Dent J, 2015,9:15-20. DOI: 10.2174/1874210601509010015.
[5] Szmukler-Moncler S, Davarpanah M, Davar-panah K, et al. Unconventional implant placement part III: Implant placement en-croaching upon residual roots - a report of six cases[J]. Clin Implant Dent Relat Res, 2015,17(Suppl 2):e396-e405. DOI: 10.1111/cid.12256.
[6] Davarpahah M, Szmukler-Moncler S.Unconventional implant placement. 2: place-ment of implants through impacted teeth. Three case reports[J]. Int J Periodontics Re-storative Dent, 2009, 29(4):405-413.
[7] Davarpanah M, Szmukler-Moncler S, Rajzbaum P, et al.Unconventional implant placement. V: Implant placement through impacted teeth; re-sults from 10 cases with an 8- to 1-year follow-up[J]. Int Orthod, 2015,13(2):164-180. DOI: 10.1016/j.ortho.2015.03.015.
[8] Davarpanah M, Szmukler-Moncler S.Uncon-ventional implant treatment: I. Implant place-ment in contact with ankylosed root frag-ments. A series of five case reports[J]. Clin Oral Implants Res, 2009,20(8):851-856. DOI: 10.1111/j.1600-0501.2008.01653.x.
[9] Bourguignon C, Cohenca N, Lauridsen E, et al.International Association of Dental Traumatol-ogy Guidelines for the management of traumat-ic dental injuries: 1. Fractures and luxations[J]. Dent Traumatol, 2020,36(4):314-330. DOI: 10.1111/edt.12578.
[10] Buser D, Warrer K, Karring T.Formation of a periodontal ligament around titanium im-plants[J]. J Periodontol, 1990,61(9):597-601. DOI: 10.1902/jop.1990.61.9.597.
[11] Warrer K, Karring T, Gotfredsen K.Periodontal ligament formation around different types of dental titanium implants. I. The self-tapping screw type implant system[J]. J Periodontol, 1993, 64(1):29-34. DOI: 10.1902/jop.1993.64.1.29.
[12] Hürzeler MB, Zuhr O, Schupbach P, et al.The socket-shield technique: a proof-of-principle report[J]. J Clin Periodontol, 2010,37(9):855-862. DOI: 10.1111/j.1600-051X.2010.01595.x.
[13] Schwarz F, Mihatovic I, Golubovic V, et al.Dentointegration of a titanium implant: a case report[J]. Oral Maxillofac Surg, 2013,17(3):235-241. DOI: 10.1007/s10006-012-0378-x.
[14] Smojver I, Katalinić I, Vuletić M, et al.Guid-ed bilateral transcanine implant placement and implant-supported oral rehabilitation in a patient with progressive systemic sclero-derma[J]. Case Rep Dent, 2021,2021:5576595. DOI: 10.1155/2021/5576595.
[15] Chu SJ, Salama MA, Salama H, et al.The dual-zone therapeutic concept of managing immediate implant placement and provi-sional restoration in anterior extraction sockets[J]. Compend Contin Educ Dent, 2012,33(7):524-532, 534.
[16] Zhang S, Li X, Qi Y, et al.Comparison of autogenous tooth materials and other bone grafts[J]. Tissue Eng Regen Med, 2021,18(3):327-341. DOI: 10.1007/s13770-021-00333-4.
[17] Gual-Vaqués P, Polis-Yanes C, Estrugo-Devesa A, et al.Autogenous teeth used for bone grafting: a systematic review[J]. Med Oral Patol Oral Cir Bucal, 2018,23(1):e112-e119. DOI: 10.4317/medoral.22197.
[18] Lee Y-K, Wadhwa P, Cai H, et al.Micro-CT and histomorphometric study of bone re-generation effect with autogenous tooth bi-omaterial enriched with platelet-rich fibrin in an animal model[J]. Scanning, 2021,2021:1-7. DOI: 10.1155/2021/6656791.
[19] Kizildağ A, Taşdemir U, Arabaci T, et al.Evalu-ation of new bone formation using autogenous tooth bone graft combined with platelet-rich fibrin in calvarial defects[J]. J Craniofac Surg, 2019, 30(6):1662-1666. DOI: 10.1097/SCS.0000000000005413.
[20] Zhou Y, Sun F, Zhang Z, et al.Influence of Er:YAG laser irradiation on the outcomes of alveolar ridge preservation at the infected molar sites: a randomized controlled trial[J]. BMC Oral Health, 2023,23(1):317. DOI: 10.1186/s12903-023-02996-y.
[21] Sculean A, Schwarz F, Becker J.Anti-infective therapy with an Er:YAG laser: in-fluence on peri-implant healing[J]. Expert Rev Med Devices, 2005,2(3):267-276. DOI: 10.1586/17434440.2.3.267.
[22] Kriechbaumer LK, Happak W, Distelmaier K, et al.Disinfection of contaminated metal implants with an Er:YAG laser[J]. J Orthop Res, 2020,38(11):2464-2473. DOI: 10.1002/jor.24662.
[23] Aoki A, Mizutani K, Schwarz F, et al.Perio-dontal and peri-implant wound healing fol-lowing laser therapy[J]. Periodontol 2000, 2015,68(1):217-269. DOI: 10.1111/prd.12080.
[24] Knutsson K, Lysell L, Rohlin M.Postopera-tive status after partial removal of the man-dibular third molar[J]. Swed Dent J, 1989,13(1-2):15-22.
[25] Langer L, Langer B, Salem D.Unintentional root fragment retention in proximity to den-tal implants: a series of six human case re-ports[J]. Int J Periodontics Restorative Dent, 2015,35(3):305-313. DOI: 10.11607/prd.2410.
[26] Nevins ML, Langer L, Schupbach P.Late dental implant failures associated with retained root fragments: case reports with histologic and SEM analysis[J]. Int J Periodontics Restorative Dent, 2018,38(1):9-15. DOI: 10.11607/prd.3463.