Clinical Evaluation Of Immediate Placement And Loading Of Dental Implants Used In Patients With Severe Periodontitis

Objective To evaluate the clinical efficacy of immediate implant placement and immediate loading in patients with severe periodontitis,and to compare the stability of hard and soft tissue of implants placed in different sites,so as to provide data support and clinical reference for the design of implant surgery in patients with severe periodontitis.Methods 23 patients with severe periodontitis were enrolled from January 2017 to March 2019,including 17 males and 6 females,with an average age of 61.87±11.58 years.Every patient received periodontal treatment and controlled acute inflammation before procedure.159 implants were placed after the unreserved teeth were extracted during the procedure,of which 62 implants were placed immediately in the extraction sockets,and 97 implants were placed in the healed sites.All implants were immediately loaded within 24 hours using provisional prostheses and the definitive prostheses were completed after 6 months.X-rays were taken at the time of immediate loading,when the definitive prostheses were completed,1 year and 2 years to calculated the marginal bone loss.The modified plaque index,the modified sulcus bleeding index and incidence of peri-implant diseases were recorded at 1 year and 2 years after permanent restoration,and the implant survival rate under this treatment procedure was observed.SPSS 25.0 software package was used to analyze the data.Results 1.One implant failed in 4 months after implantation,resulting in an accumulative survival rate of 99.4%.The survival rate was 98.4%in the post-extraction sites,100%in the healed sites.2.The marginal bone loss of implants in post-extraction sites at the definitive prostheses were completed,1and 2 years were(0.52±0.16)mm、(0.76±0.22)mm、(0.88±0.27)mm,which of implants in healed sites were(0.48±0.14)mm、(0.71±0.21)mm、(0.80±0.23)mm,the differences were not statistically significant(P>0.05).3.There were no statistical differences in the modified plaque index,modified sulcus bleeding index between the post-extraction sites and healed sites(P>0.05).4.1 year after restoration,the incidence of peri-implant mucositis in post-extraction sites and the healed sites was 21%and 18.6%,respectively.2 years after restoration,the incidence of peri-implant mucositis in post-extraction sites were 38.7%,the incidence of peri-implantitis was 1.6%.Peri-implant mucositis in healed sites were 32%.There was no significant difference in peri-implant disease incidence between the post-extraction sites and healed sites at different time points after restoration(P>0.05).Conclusion On the premise of strict control of periodontal inflammation and reasonable selection of cases,patients with severe periodontitis can undergo immediate implant placement and immediate loading to obtain satisfactory clinical results,and the condition of the soft and hard tissues around the implants in different sites maintains stably.However,the efficacy of this program still needs to be verified by large-scale and long-term clinical studies.