A Clinical Study Of Implants Immediately Placeed Into Sites With Chronic Periapical Pathology

Objective: To evaluate the success of dental implants placed immediately into extractionsites with chronic periapical lesions by observing the difference of indicators between the study group and the control group at the 4th month and the 6th month.And discuss the technical difficulties and strategies during treatment in order to provide a reference for implants placed immediately into chronic periapica lesions.Materials and Methods: Patients were collected according to the method of continuous enrollment.Patients whose posterior teeth were not able to retain due to chronic periapical infect or loss treated with implantation in the Affiliated Stomatological Hospital of Nanchang University from July 2017 to September 2018 were selected.According to the inclusion criteria,the final results were as follows:study group(Chronic perapical infected sites with immediate placement of implant):a total of 15 implants(12 implants in molars,3 in premolars)in 12 patients,including 5males with 6 implants,7 females with 9 implants;control group(more than 3 months healing period sites with implant treatment):a total of 12 patients with 16 implants(14implants in molars,2 in premolars),including 9 males with 13 implants,3 females with 3 implants.X-ray were taken after surgery,sutures were removed 10 days later,and single crown repairs were performed in 3-4 months.The patients were followed up for 4 months and 6 months after surgery.Record the resonance frequency value(ISQ value),probe depth(PD),modified bleeding index(mBI),and the implant marginal bone loss(MBL).And record implants survival rate and patient satisfaction.From implant surgery to follow-up examination,all operations are performed by one doctor,and all measurements are performed by one assistant.All paralleling technique radiograph are done by one technician.Result: There were no significant differences in age,gender,and tooth position between the two groups.In the study group,one of the implants showed fistula on the buccal side 3 months after operation,and pus was discharged.The periapicalradiograph was taken showing that there was a shadow arround the apical of implant.The apical granulation of the implant was performed.The recurrence occurred two weeks later.According to the evaluation criteria,the implant was considered a failure,and the other 14 implants in the study group remained.The radiogragh showed no shadow around the implant.The survival rate of the study group was 93.3%,and the control group was 100%.Fisher's exact probability method calculated that P=0.484 was greater than 0.05,and the difference between the two groups was not statistically significant.Four months after surgery,the ISQ value of the study group was 79.42±3.09,and the control group was 80.75±3.83.The paired samples t-test showed that P was0.98,less than 0.05,and the difference was not statistically significant.PD at the 4th month and 6th month:the 4th month: 4.13 ± 0.17 mm in the experimental group,4.14 ± 0.25 mm in the control group,t=0.04,P=0.96;the 6th month :1.38 ± 0.06 mm in the experimental group,1.52 ± 0.05 mm in the control group,t=-1.68,P= 0.11,the difference was not statistically significant.mBI :the 4th month:P=0.57,the 6th month:P=0.49;The difference was not statistically significant.Loss of marginal bone of implant;At the 4th month,the mesial marginal bone loss was 0.66±0.18 mm in the study group and 0.52±0.13 mm in the control group,P=0.54.The distal marginal bone loss was 0.63±0.22 mm in the experimental group and 0.76 ± 1.78 mm in the control group,P=0.64.Mesial marginal bone loss at 6months: 0.46 ± 0.10 mm in the experimental group,0.31 ± 0.09 mm in the control group,P=0.28;distal marginal bone loss at 6 months: 0.35 ± 0.29 mm in the experimental group,0.11± 0.11 mm in the control group,P=0.09;The differences were not statistically significant.The P of patient satisfaction was 0.73,and the difference was not statistically significant.Conclusion: Patients with chronic periapical inflammation treated with immediate placemen after careful debridement of the extraction socket and anti-inflammatory treatment can achieve stable effect in short-term observation.Implants immediately placed into sites with chronic periapical pathologycan achieve site preservation and reduce bone resorption.