Elamrousy et al., Dentistry 2012, 3:2 DOI: 10.4172/2161-1122.1000161 Open Access Research Article Volume 3 • Issue 2 • 1000161 Dentistry ISSN: 2161-1122 Dentistry, an open access journal Radiographic Bone Changes around Immediately Placed Immediately Restored Dental Implants in Periodontally Compromised Sites Elamrousy WA 1 *, Nassar M 1 , Ragheb AM 2 , Alnomany FA 1 and Marzok MA 3 1 Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Tanta University, Egypt 2 Department of Oral Pathology, Faculty of Dentistry, Tanta University, Egypt 3 Department of Veterinary Surgery, Faculty of Veterinary, Kafrelsheikh University, Egypt Abstract Background: The aim of this study is to evaluate radiographic success of immediately restored dental implants placed immediately after extraction of periodontally compromised anterior teeth. Methods: In this prospective clinical trial human study, ten patients were selected from outpatient clinic of the Department of Oral Medicine, Periodontology, Oral Diagnosis, and Radiology, Faculty of Dentistry, Tanta University. Teeth were extracted as a result of sever periodontal destruction, followed by immediate implant placement and immediate implant restoration. Implant survival, bone level was evaluated for each patient at 6, 9 and 12-month follow-up period. Subtraction radiography was performed to compare the baseline image from 12 months follow up period image. Results: The survival rates of the immediately placed implants in the present study were 100%. Results showed signifcant reduction of the bone defect depth at 6, 9 and 12 months when compared to immediate post-operative record. Also massive increase of the mean bone density scores at 12 months when compared to immediate post operative record. Conclusion: Based on the results of this clinical trial, placement of implants immediately in fresh extraction sockets affected by periodontal disease followed by immediate restoration may be a valid operative technique that leads to predictable results if adequate preoperative and postoperative care is taken. *Corresponding author: Walid Aly Elamrousy, Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Tanta University, Egypt, Tel: +201005724781; E-mail: perioking1@gmail.com Received July 27, 2013; Accepted October 10, 2013; Published October 12, 2013 Citation: Elamrousy WA, Nassar M, Ragheb AM, Alnomany FA and Marzok MA (2013) Radiographic Bone Changes around Immediately Placed Immediately Restored Dental Implants in Periodontally Compromised Sites. Dentistry 3: 161. doi:10.4172/2161-1122.1000161 Copyright: © 2013 Elamrousy WA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Keywords: Bone loss; Dental implants; Immediate loading; Periodontal disease Introduction Today, the placement of implants immediately afer tooth extraction has proven to be a predictable treatment strategy with a very high success rate [1]. Several authors [2-5] carried out immediate loading of implants placed in fresh extraction sockets in the anterior (premolar to premolar) region to maintain an excellent sof tissue esthetic profle around the implant-prosthetic restoration with a survival rate of 100%. However, contradictory results were reported by Chaushu et al. [6] with cumulative survival rate of 82.4% for implants placed in fresh extraction sockets and 100% for implants placed in healed ridges. Te defnition of periodontally compromised/periodontally susceptible patients has been used when evaluating survival and success rates of implants, because periodontal disease has been considered a risk factor for implant therapy. Greater long-term periimplant marginal bone loss versus periodontally healthy subjects, sometimes statistically signifcant, has been observed in this category of patients [7,8]. Immediately loaded implants present an alternative treatment modality for periodontally compromised patients that might provide a better opportunity to meet patient needs [9]. Still, there are relatively few long-term prospective studies of immediately restored implants and even fewer in periodontally susceptible patients [10,11]. Also, few studies [12-14] have focused on immediate loading of implants placed in fresh extraction sockets, with limited data for sof tissue measurements around implants, the aims of the present clinical study were to evaluate the implant survival and the Peri-implant radiographic changes around immediately provisionalized dental implants placed in fresh extraction sockets in periodontal compromised sites, without GBR procedure. Materials and Methods Patient selection Ten patients were selected from outpatient clinic of the Department of Oral Medicine, Periodontology, Oral Diagnosis, and Radiology, Faculty of Dentistry, Tanta University. All patients were provided with written and verbal information about the study and those who fulflled the criteria were invited to participate in the study. All patients were given informed consent to participate in the study and had the right to withdraw from the study at any time, without consequences to their future care. Patients were selected according to the following criteria: age ranged from 28 to 37 years of both sexes (four males and six females), adequate bone height apical to the alveolus of the failing tooth (≥ 5 mm) to ensure primary implant stability, good oral hygiene, completion of skeletal growth, with nil growth considerations afecting implant therapy, psychological acceptance to dental implants and the involved procedures as explained to each patient, and patients should be in apparent good health with no contraindications for surgery, patients with sever periodontitis (chronic or aggressive periodontitis) with anterior periodontally hopeless teeth based on clinical and radiographic assessments. Teeth were characterized as hopeless if they presented with two or more of the following criteria: loss of 75% of the supporting bone; probing depth (PD) >8 mm; Class III furcation involvement or grade III mobility; poor crown/root ratios; root proximity; and a history of periodontal abscess. D e n ti s t r y ISSN: 2161-1122 Dentistry