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accepted protocol for placing dental implants. More than 15 years of research and clinical practice were needed for the -concept of
immediate endosseous implantation
into fresh extraction sites to be accepted. Today the dilemma is no longer when, but which, protocol to follow. The diverse
recommendations found in the literature leave the practitioner confused as to the methodology of choice. The conclusions drawn after
plants placed into fresh extraction sockets have a high rate of survival, ranging between 93.9% to 100%; 2) implants must be placed
3 to 5 mm beyond the apex in order to gain a maximal degree of stability; 3) implants should be placed as close as possible to the
the need for gap filling and the best grafting material; 5) the use of membrane does not imply better results-on the contrary, membrane
exposure may carry complications
in its wake; and 6) the absolute need for primary closure remains to be established. / Periodontol 1997;68:915-923.
Brnemark group'-3 have provided the dental profession with safe methods and predictable outcomes of implant dentistry. Their
implant.1
Bone loss after tooth extraction remains an important is
sue in dentistry.4 Woelfel et al.5 listed 65 factors conducive to bone rsorption associated with removable dentures, which were grouped
under 5 major headings: anatomic, physiologic, metabolic, behavorial, and miscellaneous. A
combination of any of these factors might be regarded as etiologic in the individual patient. Today, over 20 years later, little is still known
about major elements or mediators that influence bone rsorption. Anatomically, bone rsorption oc
curs both buccolingually and apicocoronally,6 and the first 6 months postextraction are critical, carrying the highest rate
*Department of Oral and Maxillofacial Surgery, The Maurice and Ga-briela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel.
'Department of Oral and Maxillofacial Surgery, Chaim Sheba Medical Center, Tel-Hashomer, Israel.