Immediate Implant Placement in the Esthetic Zone:
Optimizing Soft Tissue Outcomes Conservatively
Presented by Dr. Guido Sarnachiaro
Immediate implant placement offers advantages to both the patient and the clinician with fewer surgical procedures and reduced treatment time. While immediate placement in the esthetic zone does present unique challenges, improvements in implant design and provisional restoration techniques can provide the benefits of immediate placement with success rates comparable to delayed protocols. The proper fabrication of an immediate provisional is critical for soft tissue preservation and ultimate success of the case. Additional factors such as proper surgical placement (tridimensional alignment) of the fixture, adequate contours of the provisional and filling the gap around the implant with graft material combine to make a predictable protocol for immediate implant therapy. Clinicians must also plan for the various types of extraction sockets in immediate cases, which can be identified based on the integrity of the bony walls. A socket classification will be discussed and a stepby-step socket specific protocol will be presented on how to fabricate the proper screw retained provisional restoration, from the fabrication of the acrylic shell to managing and capturing the proper supportive subgingival contour. The need for guided bone regeneration for preservation of the bony walls will also be addressed. Attendees will participate in a handson exercise to learn techniques for fabrication of the immediate provisional and preservation of the surrounding soft tissue.
Dr. Sarnachiaro received his dental degree from the Universidad de Buenos Aires Facultad de Odontologia, graduating magna cum laude. He completed his Oral Surgery Residency Program in the Hospital Interzonal de Agudos Eva Peron and obtained his certificate in Prosthodontics at the Instituto Cientifico Buenos Aires. Dr. Sarnachiaro completed a Fellowship Program in Oral Implantology as part of the University of Pittsburgh’s continuing education program in Argentina. Relocating to the United States in 2003, he received his U.S. DDS degree from the New York University College of Dentistry (NYUCD), once again graduating with honors. He is currently Assistant Clinical Professor at the Columbia University College of Dental Medicine’s Department of Prosthodontics, and at the Temple University School of Dentistry’s Department of Periodontology-Oral Implantology. He is a Clinical Professor at the Maimonides University School of Dentistry and has done extensive research in the fields of dental implants and related biomaterials. He has lectured throughout the United States, and in Argentina, Brazil and Italy.