Laser Therapy for Infected Sites and Immediate Dental Implan
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Placement of post extraction dental implants has become a common practice, due to its numerous advantages, such as it facilitated maintenance of the horizontal and vertical dimensions of the osseous tissue, reduced treatment times, enhanced patient comfort, and good esthetic results. The immediate implant placement technique was first described by Lazzara in 1989 . However, only a small number of studies report the clinical outcomes of immediate implants inserted in postextraction sockets.

Here presents the case of a 40-year-old woman with a compromised upper left lateral incisor presenting with clinical and radiological signs of an infection, particularly periapical periodontitis. The tooth had been unsuccessfully treated with apicectomy. The patient was in good general health and had a good oral hygiene and was motivated to begin the treatment. The dentist decided to proceed with a post extraction dental implant, considering the conditions and the area of high esthetic value.

Optocain® was used as local anesthetic, and tooth 2.2 was extracted as atraumatically as possible. The full thickness flap was carried out by a crestal incision with vertical releases. The postextraction site was treated with the ErCr : YSGG 2780 nm laser device Waterlase iPlus® with handpiece gold having two modes of operation. The site was debrided and decontaminated after extraction using the same laser device while mounting a MZ-6 tip and 9 mm in length. Debridement time depended on the amount of pathological tissue and bone volume, whereas decontamination lasted from 60 to 90 seconds per socket, ensuring no physical contact between the tip and the tissues.The implant was inserted with a minimum 35 N torque and 1 mm below the most apical bone peak. Bio-Oss® and GUIDOR matrix barriers were used to improve bone healing . The suture was placed with particular care to obtain primary closure over the implant. postoperatively administration of amoxicillin (1 gr ×2/day for 6 days) and chlorhexidine gluconate 0.20% was done twice daily for 15-20 days. The temporary prosthetic phase before loading was managed with a Maryland bridge. The implant was loaded after 4 months, and a clinical check 2 years later demonstrates satisfactory esthetic outcomes. Radiographic checkups were scheduled on the 1st, 4th, 8th, and 12th months in the first year .

Conclusively, There were no complications such as peri-implantitis or loss of peri-implant bone. The implant achieved good primary stability, immediate placement into an infected site did not increase complications, and the 5-year follow-up confirmed the treatment success.

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