Immediate Molar Implant Placement With Planned Immediate Restorative Management: A Retrospective Descriptive Case Series

Immediate molar implant placement requires management of complex socket anatomy, infection, residual bone, and posterior loading. This retrospective descriptive case series evaluates the recorded clinical use of a restoratively driven protocol with planned immediate restorative management.

This retrospective descriptive series included 46 patients with 46 molar sites treated over the preceding five years, comprising 23 maxillary and 23 mandibular sites in private practice. The series comprised 46 patients with one listed treatment site per patient, treated during the five years preceding this retrospective review. Eligible cases involved failing molars planned for immediate implant placement; the sole exclusion criterion was an extraction site too large to permit immediate placement. Nicholas Fahey performed all procedures and managed or reviewed the available follow-up records. Patients were reviewed at two and eight weeks, and the restorative phase was initiated at 12 weeks. Site-level data were summarized descriptively.

Pre-existing infection was recorded in 37 of 45 sites with documented status (82.2%); one status was missing. Forty-five entries recorded insertion torque of 25-80 N·cm. Provisional materials were zirconia in 24 sites, polymethyl methacrylate in 18, and composite in three. The reported complications were postoperative pain in maxillary case 12, a loose custom healing abutment in maxillary case 15 that was tightened at the initial postoperative visit, and slight recession at the custom healing abutment in mandibular case 15. Mandibular case 20 lacked primary stability, and placement of the custom healing abutment was delayed. No additional complications were documented in the available records. Illustrated follow-up extended to 53 weeks in the maxillary case and two years in the mandibular case.

This retrospective series describes the clinical application of immediate molar implant placement with planned immediate restorative management in private practice. The reported complications were limited, and the protocol was modified in one site by delaying custom healing abutment placement when primary stability was inadequate. Complete site-level observation periods and standardized endpoint data are needed to estimate implant survival or comparative effectiveness.