A staged approach of implant placement in immediate extraction sockets for preservation of peri-implant soft and hard tissue

Esthetic zone restoration is a challenging aspect in implant dentistry because of two critical factors such as level of bone support and soft tissue dimensions. Preservation of healthy peri-implant tissues is of primary importance for ensuring better esthetics over an extended period. The aim of the present case-series was to evaluate a new staged approach of implant placement in immediate extraction sockets for preservation of peri-implant soft and hard tissues. Four subjects scheduled for extraction of teeth in the esthetic zone with neither a periapical nor periodontal infection and with thick tissue biotype were included. For all the subjects sand blasted, large grit, acid etched platform switched implant with a diameter 2 mm less than the diameter of extraction socket and a conical abutment-implant connection (Morse taper) were placed 2 mm below the crest of the socket, with almost 2 mm gap between the labial plate and the implant with shoulder placed palatally/lingually. The implants were loaded after 2 months healing period and followed for a period of 1-2 years. In all the four patients there was preservation of both hard and soft tissues around the implant with a good esthetic outcome in all the follow up visits. Integrating immediate placement with stable implant-abutment connection, platform switching concept and careful case selection, we can achieve a very good esthetic outcome.