IMPACT OF TREATED PERIODONTITIS HISTORY ON PRIMARY STABILITY AND EARLY COMPLICATIONS OF IMMEDIATE DENTAL IMPLANTS: A COMPARATIVE CLINICAL STUDY

Introduction:  The use of dental implants has revolutionized modern dentistry as now we have the ability to replace missing tooth structure without damaging or involving adjacent teeth. This also provides an option for fixed prosthesis in edentulous regions. The aim of the study is to answer the frequently debated question whether implant therapy in individuals with previous periodontitis associated tooth loss is associated with an increased incidence of implant loss and periimplantitis. Taking into account the lack of data available on local population in this regard the purpose is to have a better understanding of outcomes of implant therapy in this patient population. Objective: To determine immediate implant stability in patients requiring replacement of one or more teeth and to compare immediate implant stability in patients with and without history of treated periodontitis. Subject and methods: Descriptive Case Series conducted in Dental Department, Pakistan Institute of Medical Science (PIMS) Islamabad from June 2019 to June 2021. Screening of patients was done by history taking, clinical examination and radiographic evaluation of bone of the jaw. Patients filled into group A (with no history of periodontitis) and group B (with previous history of periodontitis). After the pre-surgical preparation for the placement of the implants, the surgery was conducted under aseptic conditions. The corresponding drilling was performed using a physio dispenser with torque control handpiece with abundance of Normal Saline irrigation, and the drilling speed and the initial torque used for the insertion of the dental implants was recorded. After finishing the surgical procedure, periapical radiographs were taken of the area. Patients of both groups were kept at 6 week and 3 months follow up. At each follow up visit clinical evaluation of the primary implant stability was done. Results: In Group A, 04 (13.3%) patients had foreign body sensation while in Group B, 15 (50%) patients were having foreign body sensation. In Group A, 04 (13.3%) patients were recorded with dysesthesia while in Group B, 10 (33.3% patients were recorded with dysesthesia. In Group A, 07 (23.3%) patients experienced pain while in Group B, 21 (70.0%) patients experienced pain. Conclusion: Based on the outcomes of the present study, it can be concluded that immediate implant placement with immediate loading may be a viable treatment option for cases requiring earliest restoration of teeth to be extracted. However, this approach is considered highly technique sensitive and requires expert dental implant team for its execution. Careful selection of cases, proper treatment plan and follow-up of surgical and prosthetic protocols are the keys to success.