Prognosis of 3 mm diameter two-piece implants immediately placed after anterior teeth extraction

Implant placement immediately after tooth extraction has many advantages, including fewer surgeries and a shorter treatment period. The procedure is often performed in the anterior teeth that require rapid aesthetic restoration. This study examined the prognosis of two-piece narrow-diameter implants (NDIs) in the implant placement immediately after extracting the mandibular incisors and maxillary lateral incisors that require high strength in narrow locations. This study was conducted using 3.0 mm two-piece NDIs (TS III SA, Osstem Implant Co., Seoul, Korea) placed immediately after anterior tooth extraction at the Inje University Sanggye Paik Hospital Department of Oral and Maxillofacial Surgery from 2017 to 2023. Sixteen implants (three in the maxilla and 13 in the mandible) were placed in 13 patients (four males and nine females). The primary reasons for tooth extraction included periodontal disease, dental caries, and dental trauma. The implant stability quotient (ISQ) values measured by Osstell ISQ were recorded immediately after implant placement and before impression taking. The 3.0 mm two-piece NDIs placed immediately after anterior tooth extraction varied in length: 10.0 mm in six cases, 11.5 mm in seven cases, and 13.0 mm in three cases. Bone grafting was performed in six cases; three implants used both bone grafting and a membrane, and seven implants were placed without bone grafting. Over an average post-prosthetic follow-up of 9.9 months, two 10.0 mm implants placed in the mandibular anterior region failed to osseointegrate. They were re-implanted with a 3.0 mm diameter and 13.0 mm long implant and a 3.5 mm diameter and 13.0 mm long implant, respectively, which were well retained. Two cases of failed osseointegration were encountered in 3.0 mm two-piece NDIs. The remaining implants had stable prognoses. In the mandibular anterior region, the placement of a two-piece NDI immediately after tooth extraction appears to require great care. (JOURNAL OF DENTAL IMPLANT RESEARCH 2024;43(4):77-82)