Case Selection and Treatment Protocol for Immediate Dental Implants in the Esthetic Zone

Exclusion Criteria

• •1. Patient reports tobacco use within the last five years. Tobacco use for this study is defined as a current smoking habit with moderate or heavy smoking (more than 10 cigarettes per day) or tobacco chewing use.
• •2. History of alcoholism or drug abuse within the past 5 years.
• •3. Severe wear with an etiology of bruxism or clenching habits.
• •4. Patient has significant untreated periodontal disease (grade III or IV), caries, or clinical or radiographic signs of infection within two adjacent tooth positions of implant area.
• •5. History of HIV infection, Hepatitis B or C.
• •6. Patients with a history of systemic disease that precludes standard dental implant therapy or alters daily activities to a level consistent with ASA (American Society of Anesthesiologists) III classification (including cardiovascular, hepatic, renal, gastrointestinal, metabolic, neurologic, pulmonary, endocrine, autoimmune, or psychiatric disorders).
• •7. Presence of local inflammation or mucosal diseases such as lichen planus.
• •8. Patient history consistent with high risk for subacute bacterial endocarditis.
• •9. Current hematological disorder or warfarin (or similar) therapy.
• •10. Patient has a disease that affects bone metabolism, such as, but not limited to, osteoporosis, hyperthyroidism, hyperparathyroidism, congenital connective tissue disorders (e.g., osteogenesis imperfecta), or Paget's disease.
• •11. Patient is taking medications or having treatments known to have an effect on bone turnover, including: thiazide diuretics, calcitonin, systemic steroids, bisphosphonates, vitamin D (\>800 IU/day), estrogen or progesterone therapy.
• •12. Current steroid treatment: defined as any person who within the last two years has received for two weeks a dose equivalent to 20 mg hydrocortisone.
• •13. Patient currently undergoing chemotherapy.
• •14. Patient history of radiation treatment to the head or neck.
• •15. Physical or mental handicaps that would interfere with patient's ability to exercise good oral hygiene on a regular basis.
• •16. Use of any investigational drug or device within the 30 day period immediately prior to implant surgery.
• •17. Patient is pregnant.
• •18. Extraction sites having anatomic conditions that preclude immediate implant placement.