Immediate Implant Placement at a Periapical Lesion Site: A Case Series

Case 1. (a) A periapical radiograph of tooth #30 (marked with an asterisk) shows a periapical lesion. (b) An occlusal view shows a buccal sinus tract connected to a mesial root lesion (marked with an arrow). (c) Extraction of tooth (#30) shows a preserved alveolar septum and surrounding bone and gingiva. (d) The implant is placed in the extracted socket. (e) The gap between the bone and implant is filled with Bio-Oss Collagen and covered with TERUPLUG. (f) Figure-of-eight suturing is performed. (g) A radiograph shows the stably installed implant using the septum and apical bone. (h and i) Over the 25-month periodic-recall follow-up period, no specific complication is observed.

Case 2. (a) A palatal view shows a buccal-gingival fit inside the periapical lesion (tooth #19, marked with an arrow). (b) A periapical radiograph of tooth #19 (marked with an asterisk) shows a periapical lesion and suspicious root fracture. (c) Tooth (#19) is extracted with minimal trauma. (d) The tooth is extracted after separation with a diamond bur. (e) The implant is placed in the extracted socket, achieving initial stability with the alveolar septum. (f) The gap between the bone and implant is filled with Bio-Oss Collagen and covered with TERUPLUG, and then, interrupted suturing is performed. (g) A radiograph shows the stably installed implant using the septum and apical bone. (h) One month after treatment, the healing abutment surrounding the gingiva is healing well. (i) Over the 24-month periodic-recall follow-up period after implant prosthesis installation, no specific complication is observed.

Case 3. (a) A clinical photograph shows a buccal gingival sinus tract connected to a periapical lesion on tooth #7 (marked with an arrow). (b and c) The four-unit bridge including the teeth (#7 and #10) is extracted with minimal trauma. (d) The implant is placed in the extracted sockets. (e) The gap between the bone and implant is filled with Bio-Oss Collagen and covered with TERUPLUG. Figure-of-eight suturing was performed. (f) A radiograph shows the stably installed implant. (g) One month after treatment, the healing abutment surrounding the gingiva is healing well. (h) Over the 30-month periodic-recall follow-up period after implant prosthesis installation, no specific complication is observed. (i) A radiograph shows a stable osseointegrated implant.