[Immediate implants without primary stabilization in the molar region].

Primary stabilization of implants was always considered a prerequisite for success. However, in many cases of extraction of molar teeth, the size of the extraction socket is larger than the widest implant available. A technique for immediate replacement of molar teeth with implants placed in bone allograft or xenograft is described. Following careful extraction of the tooth and thorough debridement of the socket, the bone graft is placed and carefully condensed. The implant carrier screw is slightly released and the implant inserted with careful rotation. Following placement of the cover screw the socket is covered with a membrane and primary closure of soft tissue is achieved. Case 1 Tooth 47 with primary endodontal periodontal-endodontal lesion is extracted and immediately replaced with a 6 mm implant. Six months later following second stage surgery, the implant is progressively loaded for one year and the final crown is placed. Case 2 Tooth 37 with a history of repeated abscesses, a perforation to the furcation area is diagnosed and the tooth extracted. The socket was filled with bovine bone xenograft and a 6 mm implant placed. Six months later the implant was evaluated and second stage surgery performed. Following six months with temporary crown, a final porcelain crown was fabricated. This technique can be used in cases where primary stabilization of immediate implants cannot be achieved and there is a demand for a single surgical procedure. A careful surgical protocol will yield predictable results and will preserve hard and soft tissues following tooth extraction.