Ultra-Sonic Bone Surgery for tooth extraction and implant placement

Objectives: To study the reliability of ultra-sonic bone surgery (USBS) performing rehabilitation procedures, including atraumatic tooth extraction and immediate implants placement in extraction sockets.

Methods: 12 patients whit a total of 23 teeth scheduled for extraction were included. Treatment consisted in immediate implant placement according to 1-stage procedure. Extracted teeth in the upper jaw were 9 in the anterior segment and 7 in posterior, 7 in the mandible; among them 4 were bi-radicular. Atraumatic extraction and implant osteotomy was performed with UBS©. Atraumatic extraction consisted into cutting the PDL fibres with sharp ultrasonic vibrating tips. Implant osteotomy was performed with conical tips of increasing diameter; the working surface was located at the apical side only. Placed implants were Ø 3.75mm x 5 and Ø 4.5mm x 18, implant length was 10 mm x 3, 11.5 mm x 9 and 13 mm x 11.Results: All teeth were atraumatically extracted after sectioning the PDL over up 5 to 10 mm in depth. Drilling the apical third of anterior extraction sockets, with the pilot tip, departing palatally from socket axis was uncomplicated compared to rotating burs. Keeping the shifted direction was simple because of the length of the tip offering a wider visual access. Drilling the thin interradicular space of the biradicular extracted teeth was also effortless, without skiding. The tips could not damage the fragile buccal aspect during osteotomy because of the apical working surface. Mean implant healing period was 2,4 months. All implants osseointegrated and have been successfully loaded for 6 to 12 months.Conclusion: Ideal implant orientation and bone preservation in extraction socket with UBS was undemanding compared to usually skiding rotational burs. Atraumatic tooth extraction and implant placement could be successfully performed with UBS since all implants have been functioning for at least 6 months.