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Q. Osseointegration In Immediate Placement Of Implants?
In routine procedures, delayed placement of implants is done. However, immediate placement of implants into fresh extraction sites is also possible in select cases. In these cases, except for the apical or the apical- lateral portion of implant, much of metal surface may not be in contact with bony walls of the socket, but in juxtaposition to the surrounding organized clot in the socket which must undergo organization process prior to pre-osseous matrix and bone formation. In humans 4-6 weeks is required for the socket to fill with cancellous bone which undergoes further modeling and stiffening prior to the formation of more lamellated structure.
About 1 mm of cortical bone adjacent to osseous wound undergoes post-surgical necrosis inspite of careful surgical technique which must be replaced with a vital bone.
Hardness of bone adjacent to implant is significantly low than bone farther away. There is less microdamage in more compliant bone adjacent to implant than in farther older bone.
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Technique: Careful re-opening of sternum and release of steinum from the underlying adhesion is done. Femoral artery and vein are exposed for going on femoro fenioral bypass
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