IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 15, Issue 8 Ver. III (August. 2016), PP 88-95 www.iosrjournals.org DOI: 10.9790/0853-1508038895 www.iosrjournals.org 88 | Page Immediate Implants- A Novel Intervention in Implant Dentistry- A Case Report Dr. Tazeen Dawood 1 , Dr. Hassan Sadek 2 , 1 Assistant Professor, Department of Periodontics, College of Dentistry , Jazan University, Jazan, Saudi Arabia. 2 Professor, Department of Oral and Maxillofacial Surgery and Implantology, College of Dentistry, Jazan University, Jazan, Saudi Arabia. Abstract: Dental implants are no longer an enigma but now a reality as we have walked out of the arena of single speciality treatments to multi- disciplinary approaches aiming at the rehabilitation of patients with missing teeth. From the past decade the golden standard of implant protocol has been replaced by new and more novel interventions owing to the advances in clinical techniques and expansion of biomaterials which has lead to a new era of modern implant dentistry, which promises better rehabilitation of missing teeth both functionally and aesthetically, shorten treatment periods, better ossteointegration of implants and a high implant success rate. This case report highlights atraumatic tooth extraction followed by immediate implant placement. A 30 year male patient was reffered to the oral implantology unit of College of Dentistry Jazan university, Saudi Arabia, with a fractured root canal failure upper left posterior tooth which required extraction followed by immediate implant placement. Clinical and radiographic examination revealed a root canal treated, grossly destructed tooth 25.Atraumatic extraction was done followed by immediate implant placement. Follow up was done every month for 4 months after which the abutment was placed, and later final prosthesis, implant showed good ossteo -integration with no signs of peri- implantitis. Keywords: immediate implant, ossteointegration, fresh extraction socket I. Introduction According to the international congress of implantology glossary, implants placed at the time of extraction of the tooth are known as immediate implants. Immediate placement of a dental implant in an extraction socket was initially described by Schulte and Heimke in 1978[1] .Reductions in the number of surgical interventions, a shorter treatment time, an ideal three dimensional implant positioning, the presumptive preservation of alveolar bone at the site of the tooth extraction and soft tissue aesthetics have been claimed as the potential advantages of this treatment modality .The morphology of the implant site, the presence of periapical pathology, the absence of keratinized tissue, thin tissue biotype and lack of complete soft tissue closure over the extraction socket have been reported to adversely affect immediate implant placement. Indications for immediate implant placement include trauma not affecting the alveolar bone ,decay without purulence, endodontic failure, severe periodontal bone loss, residual root and root fracture[2,3,4]. 1.1 Factors to be considered while placing immediate implants 1.2 Pre-surgical implant site The morphology of maxillary anteriors including premolars exhibit thinner labiobuccal bony lamella than palatal bone, but the mandibular lingual alveolar bone is thinner than labial bone. These factors should be considered in selecting the most appropriate angulation of the pilot drills, which in turn determine the longitudinal axis of the implant site to avoid perforation of alveolar bone plates .[5] 1.3 Prevention of cortical bone lamella It is important to minimize bone trauma during surgical removal of the tooth. After extraction, the socket should be thoroughly degranulated by careful curettage, choice of the implant diameter and size should be performed on the basis of the orofacial and mesiodistal diameters of the alveolus[6,7,8]. De Wijs et al (1997) concludes that immediate implant placement is only indicated when the major part of the labial cortical wall is still intact.[9] 1.4 Immediate implant placement Implants must be placed 3.0 to 5.0 mm beyond the apex in order to gain a maximal degree of stability and as close as possible to the alveolar crest level (0 to 3.0 mm) .In cases of multi-rooted teeth, the implant can be placed in the interseptal bone or in the maxillary palatal socket [10].