Immediate implants after the removal of maxillary impacted canines: a clinical series of nine patients

When impacted maxillary canines are not amenable to orthodontic traction or reimplantation, extraction is the only solution available, followed by the option of implant placement. The aim of this study was to present a surgical technique that allows placement of immediate implants following extraction of impacted maxillary canines.

Included in the study were patients with impacted maxillary canines who refused orthodontic treatment or transplantation and/or in whom the position of the canine teeth did not allow fenestration and orthodontic traction. The canines were removed, with the apical and ridge crest bone preserved to allow immediate implant placement anchored bicortically with good primary stability. The full circumference of the implants had no bone coverage except for the apical and coronal parts and were covered with bone shavings collected by the filter of the surgical aspirator during ostectomy. The definitive restorations were positioned after a healing period of 2 to 3 months. After 12 months, data were recorded relating to the clinical and radiographic condition of the implants.

Ten impacted maxillary canines were extracted from nine patients (in one patient, both impacted maxillary canines were extracted) with a mean age of 40.3 years (range, 32 to 63 years), and 10 immediate implants were placed. All the implants had primary stability with a mean Osstell value of 61.5 on the day of surgery. At 12 months of follow-up, all the implants were considered to be successful. Digital periapical radiographs demonstrated a mean peri-implant bone loss of 0.49 mm (range, 0.15 to 1.1 mm).

The removal of impacted canines followed by immediate implant placement minimizes the number of surgical interventions and the waiting time, although increased surgical skill is needed to place the implants.