Implants · patient case question
For the tooth with the periapical infection, all of the following argue against immediate implant placement EXCEPT:
Patient case: 84-year-old with a heavily restored dentition
Patient: 84-year-old man, first visit in several years.
Chief complaint: Wants his mouth checked over.
History: Medically stable, independent, no bisphosphonates, no radiotherapy. Good manual dexterity.
Findings: Radiographs show amalgam restorations in nearly all posterior teeth. On one posterior molar roughly half the coronal tooth appears absent with a clean cavity outline. A premolar looks clinically like a retained root, but radiographically the root is intact, the canal is patent, and bone support is good. A third tooth has an established periapical infection.
Show answer and explanation
Correct answer: A. The patient's chronological age
- A. CORRECT — this is the exception. CHRONOLOGICAL AGE is not a contraindication in adults. What matters is SKELETAL MATURITY at the young end and systemic health, bone quality and healing capacity at the older end. A healthy 84-year-old is a better candidate than a growing 15-year-old.
- B. Insufficient bone or a lost buccal plate prevents placing the fixture in the correct three-dimensional position.
- C. Without primary stability the implant micromoves during healing and fibrous encapsulation follows instead of osseointegration.
- D. Active periapical infection compromises healing and osseointegration and is a genuine reason to delay.