Immediate implant surgery: three-year retrospective evaluation of 50 consecutive cases

Since August 1989, 35 consecutive patients were treated with immediate implants to replace 50 teeth requiring extractions as a result of root fractures, endodontic instability, nonrestorable carious lesions, or periodontal disease. Defects relative to the implant were morphologically grouped and were treated for bone regeneration with demineralized freeze-dried crushed cancellous bone (DFDBA), e-PTFE membrane, or both. Thread exposure initially ranged from 4 to 20 threads, while implant lengths varied from 8.5 to 18 mm. The mean implant length was 15 mm, with mean thread exposure of 11.34 threads, or 54% of the threaded length of the implant. Reentry confirmed 100% thread coverage in all but one implant in the no-wall group treated with DFDBA alone. Histologic evaluation of three cases confirmed viability of the regenerated bone. The patients were followed through April 1993, with 49 implants (98%) remaining osseointegrated and functional, supporting the predictability of immediate implant placement. The age of the patients ranged from 16 to 80 years, hence implant placement considerations relative to adolescents are also discussed.