Immediate Implant Prevents Dry Socket

A 24-year-old man has poor dentition.  The tooth #14 is beyond salvageable (Fig.1).  The extraction socket is large (Fig.2).  Dry socket develops 6 days post extraction without socket preservation (Fig.3). 

The tooth #14 of a 79-year-old lady is also non salvageable (Fig.4), but this patient chooses immediate implant (Fig.5, 8x14 mm, no bone graft).  The socket heals uneventfully (Fig.6, 2 weeks postop).  The implant has been in function for 11 months.

In addition to pain associated with dry socket, the buccal plate is atrophic 10 months post extraction (Fig.7 arrowheads, 1st case).  A smaller implant (6x17 mm) is placed after bone expansion (Fig.8, bone appears to be soft).  The buccal plate morphology improves immediately (Fig.9) and 6 days (Fig.10) post implantation and bone expansion.  The patient returns for follow up 7 months postop; the implant appears to have osteointegrated (Fig.11).  The implant has been restored for 3 months (09/11/2014).

Table: Comparison of Immediate vs. Delayed Implants (*: from extraction to crown cementation)

Xin Wei, DDS, PhD, MS 1st edition 01/05/2014, last revision 09/12/2014