"Cirugía guiada de implantes inmediatos, utilizando la técnica Socket Shield"

RESUMEN: Este informe clínico describe el tratamiento rehabilitador realizado a un paciente con fracturas horizontales de ambos incisivos centrales superiores, mediante la colocación de implantes inmediatos, utilizando una guía quirúrgica y la técnica Socket Shield. Después de un año de seguimiento, no se observan alteraciones clínicas de los tejidos duros y blandos, manteniéndose una alta estética. La cirugía guiada junto a la técnica Socket Shield es un enfoque de tratamiento prometedor para la rehabilitación con implantes de la zona anterior.

ABSTRACT: This clinical report describes the restorative treatment performed on a patient with horizontal fractures on both upper central incisors, by placing immediate implants using both surgical guide and the Socket Shield technique. After one year of monitoring, no clinical hard or soft tissues alterations were observed, maintaining high aesthetics. Guided surgery together with Socket Shield technique is a promising treatment approach for anterior implant rehabilitation.

The effects of hard and soft tissue grafting and individualization of healing abutments at immediate implants: an experimental study in dogs

PURPOSE: To evaluate the effects of intra-alveolar socket grafting, subepithelial connective tissue grafts, and individualized abutments on peri-implant hard and soft tissue outcomes following immediate implant placement. METHODS: This randomized experimental study employed 5 mongrel dogs, with 4 sites per dog (total of 20 sites). The mesial roots of P3 and P4 were extracted in each hemimandible and immediate dental implants were placed. Each site was randomly assigned to 1 of 4 different treatment groups: standardized healing abutment (control group), alloplastic bone substitute material (BSS) + standardized healing abutment (SA group), BSS + individualized healing abutment (IA group), and BSS + individualized healing abutment + a subepithelial connective tissue graft (IAG group). Clinical, histological, and profilometric analyses were performed. The intergroup differences were calculated using the Bonferroni test, setting statistical significance at P<0.05. RESULTS: Clinically, the control and SA groups demonstrated a coronal shift in the buccal height of the mucosa (0.88±0.48 mm and 0.37±1.1 mm, respectively). The IA and IAG groups exhibited an apical shift of the mucosa (−0.7±1.15 mm and −1.1±0.96 mm, respectively). Histologically, the SA and control groups demonstrated marginal mucosa heights of 4.1±0.28 mm and 4.0±0.53 mm relative to the implant shoulder, respectively. The IA and IAG groups, in contrast, only showed a height of 2.6 mm. In addition, the height of the mucosa in relation to the most coronal buccal bone crest or bone substitute particles was not significantly different among the groups. Volumetrically, the IA group (−0.73±0.46 mm) lost less volume on the buccal side than the control (−0.93±0.44 mm), SA (−0.97±0.73 mm), and IAG (−0.88±0.45 mm) groups. CONCLUSIONS: The control group demonstrated the most favorable change of height of the margo mucosae and the largest dimensions of the peri-implant soft tissues. However, the addition of a bone substitute material and an individualized healing abutment resulted in slightly better preservation of the peri-implant soft tissue contour.

Implante dentário e carga imediata após a extração do incisivo lateral superior decíduo: quatro anos de acompanhamento / Immediate dental implant and loading after extraction of a maxillary lateral incisor deciduous tooth: 4 years of follow-up

Quando bem indicado, o implante imediato com carga é uma opção segura e eficiente para substituição de elementos dentais unitários condenados, com previsibilidade e altas taxas de sucesso quando se buscam fatores como conforto, estética, função e fonética. Uma técnica atraumática, aliada à habilidade do operador, e um bom remanescente ósseo são fatores determinantes no sucesso do tratamento. O objetivo desse trabalho foi apresentar um caso clínico de instalação de implante imediato em região anterossuperior com carga imediata, provisionamento com dente decíduo e prótese definitiva livre de metal, com acompanhamento de quatro anos.

When properly indicated, the immediate dental implant with loading is a safe and efficient option with predictability and high success rates for patients in need of comfort, esthetics, function, and phonetics. An atraumatic technique allied to the operator's skill and a good bone site are mandatory to the treatment success. This case reports the 4-year follow-up on the use of an immediate implant/loading procedure after extracting a maxillary deciduous lateral incisor and delivery of a metal-free restoration.

Immediate implant in single rooted teeth ‑ Study on primary stability and bone formation.

Background: Dental implants (DI) are emerging as an alternative to dentures. Immediate placement of DI for esthetic concern has been always in demand. This is a retrospective analysis of the success rate of immediately placed DI in freshly extracted single‑rooted tooth socket, by clinical, radiographical, soft and hard tissue changes in a follow‑up period of 1 year. Materials and Methods: Retrospective analysis of all cases of immediate DI placed in the single rooted socket was performed. Cases were selected based on previously established inclusion and exclusion criteria. Age, gender, tooth, jaw, cause of impending tooth loss, tooth diameter along the cervical margin, the width of keratinized gingiva (WKG), and radiographic measures were performed for up to a year. Descriptive statistics and comparison of means were presented. P ≤ 0.05 was taken as significant. Results: Of the 324 immediate DI placed in 207 patients during the study period, 61 fulfilled the criteria. There were 49.2% males 31.15% had dental caries, 61% involving maxilla. The mean age of patients was 34.82 ± 7.97 years. Mean extraction socket diameter was 4.6 ± 1.78 mm. From complete stability of DI, the WKG decreased from baseline to 3 months period and regained at 12‑month follow‑up. The difference was statistically significant (P = 0.01). The same trend was noticed in the distance of the mesial and distal papilla as measured in the probe (P = 0.075). Radiographical changes also reflected a similar trend. Discussion: The success of DI, in terms of clinical and radiographical parameters, in an immediate DI placed in a single rooted fresh extracted socket, gives adequate clinical results.

Colocación de implantes y provisionalización inmediata en el sector estético: manejo quirúrgico y rehabilitador. reporte de un caso clínico / Immediate Implant Placement and Provisionalization in the Esthetic Zone: Surgical and Prosthetic Management. Clinical Case Report

El tratamiento con implantes dentales ha demostrado ser predecible para reemplazar los dientes perdidos o defectuosos. Este caso clínico presenta un paciente con ausencia de las coronas de los incisivos centrales superiores. Luego de una evaluación clínica y radiográfica detallada del tejido blando y óseo, se realizaron las exodoncias de las raíces de los centrales superiores sin levantamiento de un colgajo, seguido de la colocación de 2 implantes, relleno óseo y provisionalización inmediata. Al paciente se le instruyó para que llevara una dieta blanda durante 3 semanas y fue evaluado semanalmente durante un mes y luego mensualmente durante un período de cicatrización de 4 meses. Después de la estabilización del tejido blando y duro, se procedió a la colocación de las coronas definitivas con aditamentos de zirconia. Los resultados que se pueden apreciar luego de la colocación de los implantes y la provisionalización inmediata en el sector estético anterior del maxilar superior nos indican un predecible grado de éxito con esta técnica. Por lo que podemos concluir que esta técnica puede ser aplicada y recomendada siempre y cuando exista un adecuado diagnóstico y protocolo de tratamiento que brinde una correcta selección del caso y asegure una tasa de éxito similar a otras técnicas.

Treatment with dental implants has shown to be a predictable treatment to replace defective or lost teeth. A clinical case is presented on a patient with absence of the crowns of the upper central incisors. After a detailed clinical evaluation of the bone and soft tissue, a root extraction without a flap elevation was performed, followed immediately by the insertion of two implants and provisional crowns and a bone graft. The patient was instructed to follow a soft diet for 3 weeks, and was followed up weekly for a month, and then monthly for a period of 4 months. After the stabilization of the soft and hard tissues, the final crowns using zirconia abutments were inserted. The results shown after placement of the immediate dental implants and provisionalization in the anterior esthetic zone of the maxilla demonstrate a predictable grade of success with this technique. In conclusion, this technique can be applied and recommended when there is an adequate diagnosis and treatment protocol that provides a correct selection of the case in order to ensure a rate of success similar to other techniques.

Implante e provisionalização imediata com resina composta em area estética / Implat and immediate temporization in the aesthetic area with composite resin

O tratamento odontológico tem como objetivo devolver ao paciente a função mastigatória e estética. A implantodontia é uma ciência que busca atingir tais objetivos e tem se desenvolvido consideravelmente nos últimos anos. O protocolo cirúrgico do implante imediato surgiu com a finalidade inicial de aproveitar a arquitetura óssea do alvéolo dentário, para facilitar a instalação do implante. Dessa forma, consegue-se eliminar o segundo estágio cirúrgico. O objetivo deste artigo é relatar um caso clínico em área estética, abordando as vantagens e desvantagens em que a realização do implante com carga imediata foi executada como opção de tratamento. A instalação de componentes protéticos imediatos reduz o tempo de tratamento, minimiza a perda do remanescente ósseo e com isso, otimiza os resultados com relação à função e a estética. Essa técnica apesar de proporcionar mais conforto e comodidade para o paciente necessita ser executada de maneira multidisciplinar e mediante um planejamento prévio criterioso.

Dental treatment aims to restore the patient?s masticatory and aesthetic functions. Implantology is the science that seeks to achieve these objectives and has developed considerably in recent years. The surgical protocol for the immediate implant has originated with the initial purpose of using the tooth socket bone architecture to facilitate the installation of the implant. Thus, the second surgical stage can be eliminated. The objective this article is to report a clinical case in the aesthetic area addressing the advantages and disadvantages where the achievement of the implant with immediate load was performed as a treatment option. The immediate installation of prosthetic components reduces treatment time, minimizing the loss of remaining bone and therefore optimizes the results regarding the function and aesthetics. Although this technique provides more comfort and convenience for the patient, it needs to be performed in a multidisciplinary manner and with a careful pre-planning.

Considerações clínicas no planejamento e instalação de implantes imediatos / Clinical considerations for immediate implant placement and treatment planning

As reabilitações implantossuportadas permitem o restabelecimento da função e da estética após perdas dentárias totais e parciais com previsibilidade e altas taxas de sucesso. A instalação de implantes imediatos com carga imediata, a fim de evitar as alterações dimensionais sofridas pelo osso alveolar e tecidos moles, após a extração dentária, apresenta algumas vantagens em relação à técnica convencional, como redução do número de procedimentos cirúrgicos, possível preservação do osso alveolar, redução de custos e do período de ausência dentária, além de maior aceitação por parte do paciente. Vários estudos têm demonstrado que implantes instalados em alvéolos frescos e com carga imediata apresentam uma taxa de sobrevivência entre 94,5% a 100%. No entanto, para que um resultado funcional e estético adequado seja obtido, é fundamental que seja realizado um planejamento preciso, lançando mão dos recursos de diagnóstico bi e tridimensionais disponíveis, para que fatores relacionados à qualidade e à quantidade óssea sejam avaliados...

Dental implant-supported restorations present predictability and high success rates in restoring function and esthetics. The immediate placement/loading of dental implants is considered an option to reduce the risk of dimensional changes due to alveolar bone resorption and soft tissue collapse following tooth extraction. Other advantages over the conventional technique are the reduced number of surgical procedures, possible alveolar bone preservation, reduced costs, shorter period for temporary crowns or bridges, and greater acceptance by the patient. Several studies have shown that implants placed in fresh sockets with immediate loading have a high survival rate between 94.5 to 100%. However, for achieving a functional and aesthetic result, adequate treatment planning is fundamental including clinical and two- and three-dimensional diagnostic approaches...

Reconstrução imediata de diferentes defeitos peri-implantares em implantes pós-exodônticos: análise histomorfométrica em cães / Reconstruction of buccal different defects at implants placed immediately into extraction sockets: a histomorphometric analysis in dogs

Objetivo: A proposta deste estudo foi avaliar a regeneração óssea de defeitos criados cirurgicamente e naturais circunferenciais (gap) de implantes pósexodônticos. Materiais e método: Para este estudo foram utilizados 8 cães da raça labrador, nos quais foram instalados implantes imediatos (pós-exodônticos) nos alvéolos dos dentes P2 (2o pré-molar) e M1 (1o molar) inferiores bilaterais. Nos implantes da região dos 2º pré-molares bilaterais foram criados cirurgicamente defeitos peri-implantares vestibulares que foram preenchidos de um lado por osso autógeno – OA e do outro por osso bovino inorgânico Bio-Oss®- OB. Nos alvéolos correspondentes aos primeiros molares (M1) os implantes foram instalados e os gaps (defeitos naturais) existente entre a tábua óssea vestibular e o implante, foram preenchidos por Bone Ceramic® - (grupo BC) ou somente coágulo (grupo COA). Todos os sítios cirúrgicos foram posteriormente recobertos por membrana de colágeno reabsorvível (Biogide ®) e mantidos com cicatrizador. Após 4 meses de pós-operatório, os animais foram eutanasiados e os blocos ósseos processados laboratorialmente para análise histomorfométrica. Resultados: Os resultados obtidos nos implantes instalados na região do P2 mostraram que os valores do IS-C foram ligeiramente maior (2.3±0.8mm) no grupo OA, comparado ao grupo OB (1.7± 0.7 mm), enquanto o IS-B dos grupos OA e OB foram respectivamente de 2.7±0.7mm e 2.2±1.0 mm no lado vestibular e de 1.6±0.8mm e 0.8±0.5mm no lado lingual. As médias dos valores de PM-C, PM-B e PM-IS no grupo OA e OB foram respectivamente de 4.3±0.9mm, 4.7±0.9mm, 2.0±1.6mm e 4.3±0.6mm, 4.8±0.6mm, 2.5±0.8mm. A diferença estatística significativa foi observada somente na espessura da crista óssea vestibular de 2 a 5 mm em direção ao IS (“pescoço do implante”), incluindo o biomaterial (S-OCbt) que se apresentou maior no grupo OB. Nos implantes instalados na região do M1, o gap vestibular horizontal foi de 1.1 (COA) e 1.4 mm (BC) e vertical de 3 e...

Objective: The purpose of these studies were to evaluate bone regeneration at natural or surgically-created buccal defects at implants placed immediately into extraction sockets (IPIES). Material and methods: Eight Labrador dogswere used and implants were placed immediately into the extraction sockets of P2 (second premolar) and M1 (first molar), bilaterally. At P2, the buccal wall of the extraction sockets was removed bilaterally to create a standardized defect, 4 mm wide coronally, 2 mm wide apically, and 6 mm height. At P2 sites, Bio-Oss at the test (OB) or autogenous bone at the control (OA) sites were used to fill the defects. At M1 sites, Bone Ceramic ® at the test (BC) or the clot alone (COA) were used to fill the defects. All surgical sites were subsequently covered by a resorbable collagen membraneand a non-submerged healing was allowed. After 4 months the animals were euthanized, bone blocks harvested and processed for histomorphometric analysis. Results: at P2 sites, IS- C values were slightly higher (2.3±0.8mm) in the OA compared to the OB (1.7±0.7 mm). IS- B were 2.7 ± 0.7mm and 2.2 ± 1.0mm on the buccal side and 1.6 ± 0.8mm and 0.8 ± 0.5mm on the lingual side at OA and OB groups, respectively. The average values of PM- C , B - PM and PM -IS in OA and OB groups were 4.3 ± 0.9mm , 4.7 ± 0.9mm , 2.0 ± 1.6mm and 4.3 ± 0.6mm , 4.8 ± 0.6mm , 2.5 ± 0.8mm, respectively. A statistically significant difference was only observed in the thickness of the buccal bony crest at 2-5 mm apically to IS (the implant neck) when the biomaterial (S -OCbt) was included in the measurement, which appeared to be higher in the OB group. At M1 sites, at the time of installation, the horizontal buccal gap was 1.1 at the COA and 1.4 mm at the BC sites while the vertical remaining defect was 3 mm and 4 mm deep in the control and test sites, respectively. At the buccal aspect, IS-C was higher in the COA (0.6 ± 1.6mm) compared to the BC (0.1 ± 1.8mm) groups and IS- B was...

Reconstrução imediata de diferentes defeitos peri-implantares em implantes pós-exodônticos: análise histomorfométrica em cães / Reconstruction of buccal different defects at implants placed immediately into extraction sockets: a histomorphometric analysis in dogs

Objetivo: A proposta deste estudo foi avaliar a regeneração óssea de defeitos criados cirurgicamente e naturais circunferenciais (gap) de implantes pósexodônticos. Materiais e método: Para este estudo foram utilizados 8 cães da raça labrador, nos quais foram instalados implantes imediatos (pós-exodônticos) nos alvéolos dos dentes P2 (2o pré-molar) e M1 (1o molar) inferiores bilaterais. Nos implantes da região dos 2º pré-molares bilaterais foram criados cirurgicamente defeitos peri-implantares vestibulares que foram preenchidos de um lado por osso autógeno – OA e do outro por osso bovino inorgânico Bio-Oss®- OB. Nos alvéolos correspondentes aos primeiros molares (M1) os implantes foram instalados e os gaps (defeitos naturais) existente entre a tábua óssea vestibular e o implante, foram preenchidos por Bone Ceramic® - (grupo BC) ou somente coágulo (grupo COA). Todos os sítios cirúrgicos foram posteriormente recobertos por membrana de colágeno reabsorvível (Biogide ®) e mantidos com cicatrizador. Após 4 meses de pós-operatório, os animais foram eutanasiados e os blocos ósseos processados laboratorialmente para análise histomorfométrica. Resultados: Os resultados obtidos nos implantes instalados na região do P2 mostraram que os valores do IS-C foram ligeiramente maior (2.3±0.8mm) no grupo OA, comparado ao grupo OB (1.7± 0.7 mm), enquanto o IS-B dos grupos OA e OB foram respectivamente de 2.7±0.7mm e 2.2±1.0 mm no lado vestibular e de 1.6±0.8mm e 0.8±0.5mm no lado lingual. As médias dos valores de PM-C, PM-B e PM-IS no grupo OA e OB foram respectivamente de 4.3±0.9mm, 4.7±0.9mm, 2.0±1.6mm e 4.3±0.6mm, 4.8±0.6mm, 2.5±0.8mm. A diferença estatística significativa foi observada somente na espessura da crista óssea vestibular de 2 a 5 mm em direção ao IS (“pescoço do implante”), incluindo o biomaterial (S-OCbt) que se apresentou maior no grupo OB. Nos implantes instalados na região do M1, o gap vestibular horizontal foi de 1.1 (COA) e 1.4 mm (BC) e vertical de 3 e...

Objective: The purpose of these studies were to evaluate bone regeneration at natural or surgically-created buccal defects at implants placed immediately into extraction sockets (IPIES). Material and methods: Eight Labrador dogswere used and implants were placed immediately into the extraction sockets of P2 (second premolar) and M1 (first molar), bilaterally. At P2, the buccal wall of the extraction sockets was removed bilaterally to create a standardized defect, 4 mm wide coronally, 2 mm wide apically, and 6 mm height. At P2 sites, Bio-Oss at the test (OB) or autogenous bone at the control (OA) sites were used to fill the defects. At M1 sites, Bone Ceramic ® at the test (BC) or the clot alone (COA) were used to fill the defects. All surgical sites were subsequently covered by a resorbable collagen membraneand a non-submerged healing was allowed. After 4 months the animals were euthanized, bone blocks harvested and processed for histomorphometric analysis. Results: at P2 sites, IS- C values were slightly higher (2.3±0.8mm) in the OA compared to the OB (1.7±0.7 mm). IS- B were 2.7 ± 0.7mm and 2.2 ± 1.0mm on the buccal side and 1.6 ± 0.8mm and 0.8 ± 0.5mm on the lingual side at OA and OB groups, respectively. The average values of PM- C , B - PM and PM -IS in OA and OB groups were 4.3 ± 0.9mm , 4.7 ± 0.9mm , 2.0 ± 1.6mm and 4.3 ± 0.6mm , 4.8 ± 0.6mm , 2.5 ± 0.8mm, respectively. A statistically significant difference was only observed in the thickness of the buccal bony crest at 2-5 mm apically to IS (the implant neck) when the biomaterial (S -OCbt) was included in the measurement, which appeared to be higher in the OB group. At M1 sites, at the time of installation, the horizontal buccal gap was 1.1 at the COA and 1.4 mm at the BC sites while the vertical remaining defect was 3 mm and 4 mm deep in the control and test sites, respectively. At the buccal aspect, IS-C was higher in the COA (0.6 ± 1.6mm) compared to the BC (0.1 ± 1.8mm) groups and IS- B was...

Implante imediato unitário em função imediata: relato de caso / Immediate single tooth implant in immediate loading: case report

A possibilidade de reabilitação oral com implantes dentários mostrou um avanço significativo nos últimos quarenta anos. Da recomendação inicial para p tratamento de mandíbulas totalmente edêntulas com próteses fixas suportadas em implantes, houve uma evolução rápida e ascendente no sentido de aprimorar os implantes dentários, bem como de agilizar a resolução dos casos clínicos. Uma proposta já documentada com sucesso na literatura científica é a possibilidade de posicionamento de implantes unitários imediatamente pós-exodontia, o que representa um grande avanço na implantodontia. O objetivo deste trabalho é relatar um caso clínico no qual foi decidido seguir a abordagem de implante imediato com aplicação da filosofia de carga imediata, o que foi realizado no intuito de diminuir o número de intervenções cirúrgicas, bem como o tempo entre a instalação do implante e a restauração protética final. aumentando, assim, a satisfação estética e funcional do paciente.

Vertical alveolar crest bone maintenance around implants in two-stage surgery: an in situ study in dogs

The aim of this study was to evaluate in situ changes in the alveolar crest bone height around immediate implant-supported crowns in comparison to tooth-supported crowns (control) with the cervical margins located at the bone crest level, without occlusal load. In Group I, after extraction of 12 mandibular premolars from 4 adult dogs, implants from Branemark System (MK III TiU RP 4.0 x 11.5 mm) were placed to retain complete acrylic crowns. In Group II, premolars were prepared to receive complete metal crowns. Sixteen weeks after placement of the crowns (38 weeks after tooth extraction), the height of the alveolar bone crest was measured with a digital caliper. Data were analyzed statistically by the Mann-Whitney test at 5 percent significance level. The in situ analysis showed no statistically significant difference (p=0.880) between the implant-supported and the tooth-supported groups (1.528 + 0.459 mm and 1.570 + 0.263 mm, respectively). Based on the findings of the present study, it may be concluded that initial peri-implant bone loss may result from the remodeling process necessary to establish the biological space, similar to which occurs with tooth-supported crowns.

O objetivo do presente estudo foi comparar in situ modificações ocorridas na crista óssea alveolar induzidas por implantes imediatos e às induzidas por dentes naturais, ambos preparados para suportarem dispositivos protéticos situados sobre a margem óssea cervical, sem carga oclusal. No grupo I, após a extração de 12 pré-molares inferiores de 4 cães adultos, foram instalados implantes do Sistema Branemark (MK III TiU RP 4,0 x 11,5 mm) e coroas totais acrílicas. No grupo II, os pré-molares, foram submetidos a preparos convencionais, sendo cimentadas coroas totais metálicas. Após 16 semanas da instalação das coroas (38 semanas após a extração), a reabsorção da crista óssea alveolar foi avaliada in situ, por meio da mensuração das peças, com paquímetro digital. Para obtenção das medidas do grupo I, os pontos de referência foram a plataforma de assentamento do implante e a crista óssea alveolar. No grupo II, a posição do limite cervical da prótese e o início da crista óssea. Os valores obtidos foram comparados pelo teste de Mann-Whitmey com nível de significância de 5 por cento. A média de reabsorção da crista óssea foi de 1,528 + 0,459 mm para o grupo I e de 1,570 + 0,263 mm para o grupo II, não havendo diferença estatisticamente significante (p=0,880) entre os grupos. Os resultados do presente estudo permitiram concluir que a reabsorção perimplantar inicial que ocorre na crista óssea resulta de um padrão de remodelação necessário para o estabelecimento do espaço biológico na área, assim como ocorre nos dentes naturais preparados para receberem próteses convencionais.

Effect of resorbable membrane on immediate placement of implant in extraction socket during periradicular surgery / 대한치주과학회지

PURPOSE: The guided bone regeneration (GBR) technique is widely used in periradicular surgery. However, there is still some controversy regarding the effectiveness of GBR in promoting bone healing after periradicular surgery. The purpose of this study was to evaluate the resorbable membrane on the osteointegration of immediate implants in sites with periradicular lesion that had been removed by periradicular surgery. MATERIALS AND METHODS: Six roots of lower second premolars and 15 roots of lower third and fourth premolars of dogs were used as control and experimental teeth, respectively. Periradicular lesions were induced only in the experimental teeth. Twelve weeks later, the control and experimental teeth were extracted and implants were placed immediately. Periradicular lesions were removed with osteotomy, curettage and saline irrigation. Resorbable membranes were used in experimental group 1 but not in experimental group 2. After 12 week of healing period, the implants were clinically not mobile and showed no signs of infection. Data obtained by histomorphometric analysis were analyzed by Kruskal-Wallis test. RESULTS: The control group showed a significantly higher bone to implant contact (BIC) (74.14+/-16.18) than experimental group 1 (40.28+/-15.96) and 2 (48.70+/-17.75)(p<0.05). However, there was no significant difference between experimental group 1 and 2. CONCLUSION: Although BIC in experimental groups were lower than in control group, immediate implant can be successfully placed at extraction socket with periradicular lesion and osseous defect. However, the use of resorbable membrane in bony defect created during periradicular surgery was questioned.