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for whom endosseous dental implants may be indicated. 1,2 In many circumstances, implants are an alternative to fixed or removable prosthetic appliances and it has been estimated that 300,000 to 428,000 endosseous dental implants are placed annually. 3 The success of implants has been attributed to their firm bone anchorage, referred to as & 8230;

f bone quality and quantity are inadequate for the placement of implants, bone augmentation procedures may be indicated. These could include the use of either bioabsorbable or non-resorbable barrier membranes and bone grafts or bone substitutes to enhance bone regeneration. 56,57 A review of the literature indicated that implants in grafted bone are successful.58 However, it was unclear as to which graft materials are most efficacious.58Accordingly, long-term, well-controlled, prospective longitudinal comparative studies are needed in this rapidly advancing area of reconstructive bone surgery. 59,60 At a consensus conference on sinus grafting and the placement of dental implants, retrospective data from sinus floor augmentation bone grafts were collected and evaluated.61Data from 38 surgeons who performed 1,007 sinus grafts and placed 2,997 implants which were monitored for 3 years or more over a 10-year period were evaluated.61Members of the conference concluded that the sinus graft should be considered a highly predictable and effective therapeutic modality, but that identification of the ideal graft material and surgical technique requires further study.61 IMMEDIATE IMPLANT PLACEMENT If an implant is to be inserted into an extraction site, the timing of the extraction is important due to the potential for postextraction bone resorption and ridge deformation. 62,63 Insertion of implants at the time of extraction (immediate placement) is viable if mechanical fixation can be achieved. 64-67 In this regard, a single histometric report on human biopsies noted that titanium plasma-sprayed implants can achieve osseointegration when placed immediately into extraction sockets.68However, the horizontal component of the peri-implant defect was a critical determinant as to the final amount of bone-implant contact.68At present there are short-term data to support immediate placement of implants.68 Alternatively, implants can be inserted after complete healing of the extraction socket. To shorten treatment time, a 2- to 3-month post-extraction implant technique has been proposed.

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