Abhijeet Bhasin
Immediate dental implant placement has been an acceptable procedure for at least the past two decades. Commonly, immediate implants have been reserved for the single rooted anterior tooth and single or bi-rooted premolar tooth. Perhaps the most important aspect of any implant surgery in accordance with the successful procedure is implant stability and bone to implant contact (BIC). Removal of molar teeth provides a challenging and intriguing dilemma due to multiple root morphology. In the case of extraction and immediate placement of dental implants preserving alveolar bone proper, particularly that of the labial and lingual plates of bone is essential in providing the optimal environment for maximizing BIC and implant stability. Also, the position of the final restoration must be considered, in relation to intra and inter arch position, occlusion, function and esthetics. Thus, minimal alveolar bone removal should be considered and attained to aid in the above factors in order to provide an acceptable surgical site for successful placement of the dental implant. Finally, and perhaps most importantly when considering immediate molar implant placement, removal of the intra-alveolar septum should be avoided to aid in increasing BIC and allowing the attainment of initial implant stability at the time of placement.