Bone Density and Maturation after Tooth Extraction in the Upper Maxillary Molar Area and a New Technique of an Immediately Loaded Implant in Soft Bone: A Case Report

Socket healing after tooth extraction is associated with bone density and maturation, which may affect the stability of primary dental implants. This report describes a case of upper left and right second molar extraction, followed by implant placement at 2 and 3 months in the same patient. Implant stability was examined using resonance frequency analysis (RFA). Primary implant stability in the healing socketvaried significantly between the two time points (2 and 3 months). For the 2-month healing period, the mesiodistal implant stability quotient (ISQ) was 43, and the buccolingual ISQ was 37. For the 3-month healing period,the mesiodistal ISQ was 73, and the buccolingual ISQ was 70. An implant with high primary stability was immediately loaded with progressive loading and a follow-up period of 3 months. The progressively loaded implant was associated with increased implant stability compared with the delay loaded implant after the 3-month healing period. This case demonstrates 2 options for the operator after tooth extraction: progressive immediate implant loading or delay loading. However, both techniques depend on the stability of the primary implant. Progressive loading is a dependable procedure for an immediately loaded implant that is placed in soft bone. Using composite and temporary abutment is applicable and convenient for temporization during healing period.