Immediate Placement of an Implant Connected to a Customized Zirconia Membrane in Compromised Sockets: First Two Case Reports

ABSTRACT The authors described a novel technique to achieve the stability of the implant immediately placed in compromised sockets without osteotomy. Digital planning of the implant and customized zirconia membrane (CZM) design and milling were previously performed in the maxilla and the mandible. The study involved two healthy patients with alveolar bone defect. The CZM was created as a single continuous piece, and uniquely dimensioned to fit the zone of the bone defect after tooth extraction. An extension was created at the inner surface of the CZM to serve as a connector or abutment used to connect the implant to the CZM, secured with an abutment screw. As no osteotomy was performed in the two cases, the assembly CZM/Implant was stabilized with fixation screws to the cortical bone. In the first case, a crestal sinus lift was performed in the maxilla, using bovine bone graft, with immediate placement of the assembly CZM/Implant after extraction of the first molar. In the second case, immediate implantation was performed after the extraction of the second molar with a large periapical lesion. A CBCT scan confirmed the good osseointegration of the implants at 2 years. As this novel technique is promising, a research study is planned to better assess clinical outcomes and validate the new concept.