IMMEDIATE IMPLANT PLACEMENT AND

LOADING ENRICHED WITH L-PRF IN

ESTHETIC ZONE
– A CASE REPORT

SAPNA YADAV
GUIDED BY-
MDS 2ND YEAR
DR. PUJA MALHOTRA
DEPT. OF
DR. MANOTI SEHGAL
PROSTHODONTICS
 INTRODUCTION
• Wang et al defined retained deciduous teeth as the
condition where succedaneous permanent teeth have
erupted while the primary teeth were retained, or the
permanent teeth unerupted while the primary teeth
remained in the permanent dentition.

Multiple retained deciduous teeth: a case report 2009 Jun;27(3):348-9

 ETIOLOGY
Aktan et al-
• Congenital absence of
successor
• Impaction, translation or
transmigration of successor
• Pathology-cysts, tumours,
odontoma
• Microdontia of permanent
dentition
.

An evaluation of factors associated with persistent primary teeth.European Journal of Orthodontics

(2012) 208–212
 Mandibular second
premolars (2.4-4.3%)
Maxillary lateral
incisor (1.6-1.8%)

Maxillary second
premolars (1.4-1.6%)

Mandibular incisors
(0.2- 0.4%)
Polder, Bart J., et al. “A meta‐analysis of the prevalence of dental agenesis of permanent
teeth.” Community Dentistry and Oral Epidemiology, Vol. 32, No. 3, 2004, pp. 217 -26.
 CONSEQUENCES

Replacing Hopeless Retained Deciduous Teeth in Adults Utilizing Dental Implants: Concepts and
Case Presentation by Michael Tischler , DDS Published: Dentistry November 2005
 TREATMENT OPTIONS

• Retain
• Retain and modify
• Extraction and space closure
• Extraction and prosthetic replacement
FPD
IMPLANT

BRITISH DENTAL JOURNAL VOLUME 207 NO. 7 OCT 10 2009New teeth from old: treatment options for
retained primary teeth S. Robinson1 and M. F. W-Y. Chan2
 IMPLANT

• Recognised as the treatment of choice

• High success and survival rates
• preservation of the alveolar crest
• elimination of the need to restore adjacent teeth
• improved esthetics and function

Pjetursson B E, Lang N P. Prosthetic treatment planning on the basis of scientifi c evidence. J Oral Rehabil 2008;
35 Suppl 1: 72–79
 IMMEDIATE IMPLANT PLACEMENT

• a shorter treatment time

• three dimensional implant
positioning
• preservation of alveolar
bone
• soft tissue aesthetics

J. Ortega-Martinez, T. Perez-Pascual, S. Mareque-Bueno, F. Hernandez-Alfaro, and E. Ferres-

Padro, “Immediate implants following tooth extraction. A systematic review,” Medicina Oral,
Patología Oral y Cirugia Bucal, vol. 17, no. 2, pp. e251–e261, 2012.
 PLATELET CONCENTRATES

PRP

PRF
 VARIOUS PRF CENTRIFUGE
PROTOCOL
T-PRF 2700 rpm 12 min
L-PRF 2700 rpm 12 min
A-PRF 1500 rpm 14 min
I-PRF 700 rpm 3-4 min

Joseph Choukroun. Regenerative innovative therapies approaches: Advanced Platelet rich

fibrin & Inject able Platelet rich fibrin-Webinar.
 CASE PRESENTATION
• A 24-year-old female patient in a good health condition without
any chronic diseases reported to the Postgraduate Department
of Prosthodontics, SGT University, Gurgaon, with a chief
complaint of abnormal-looking upper front teeth since 10 years.

Pre-operative smile view

PRE-OP INTRAORAL FRONTAL VIEW
PRE-OP OPG
SURGICAL PROCEDURE
Atraumatic extraction
ROOT LENGTH MEASUREMENTS
PREPARATION OF L-PRF MEMBRANE WITHDRAWING
VENOUS BLOOD
PRF MACHINE
PREPARATION OF L-PRF MEMBRANE
APICAL AND PALATAL PREPARATION OF
OSTEOTOMY SITE
PALATAL ORIENTATION OF THE OSTEOTOMY SITES
PRF GEL COATED IMPLANT SURFACE
PONCHO TECHNIQUE
FINAL IMPLANT PLACEMENT
POST-OP OPG
TEMPORIZATION
JIG TRIAL
FINAL CEMENTATION OF LAYERED ZIRCONIA
CROWNS
12 MONTHS OF FOLLOW-UP
 CONCLUSION

• Immediate implants may be considered a

more appropriate alternative treatment of
retained teeth than conventional therapy.

• Platelet products like PRF further enhance the

esthetics and postoperative healing.
THANK YOU!