Achieving success in
immediate implant
placement and provisionalization

Dr. Edith Groenendijk

Insights from Dr. Edith Groenendijk

Implant dentistry is a dynamic world that combines surgical precision and prosthodontic excellence in order to deliver successful patient outcomes. Dr. Edith Groenendijk, a distinguished implant surgeon and prosthodontist from the Netherlands, has been at the forefront of this synergist approach.

In a recent video interview, Dr. Groenendijk shared valuable insights from her extensive clinical experience, emphasizing the importance of real-world clinical conditions, meticulous implant positioning, and comprehensive understanding of three-dimensional biology.

A comprehensive clinical study

Dr. Groenendijk's team conducted a prospective clinical case series on 100 consecutive patients. This study was remarkable for its inclusivity. The patient pool included individuals with ideal conditions as well as those facing challenges such as trauma, inflammation, buccal bone defects, and thin gingival phenotypes. "This study was performed under clinically realistic conditions," she noted, highlighting the study's relevance to everyday clinical practice.

Nobel Biocare immediate implant placement

Dr. Groenendijk’s analysis of the prospective clinical case series

In the study, Dr. Groenendijk’s team found that "Regardless of phenotype, preoperative soft tissue recession, or excess, comparable high esthetic outcomes were achieved 1 year post-operatively.”

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Challenging conventional approach on immediate placement

One of the standout findings from Dr. Groenendijk's research was the observation that immediate implant placement did not lead to mid-facial soft tissue recession, contrary to what is often reported in the literature. By contrast, among the 40 patients with pre-operative recession, there was a notable gain in soft tissue levels. This finding underscores the potential for immediate implant placement to not only match but exceed traditional expectations regarding tissue outcomes.

The crucial role of implant positioning

A key factor in the success of immediate implant placement, according to Dr. Groenendijk, is the precise positioning of the implant. She advises placing the implant 2 - 3 mm palatally to create a wide gap that is conducive to revascularization and hard tissue formation. "In this way, a hard tissue graft is created in front of the implant to support the soft tissues in the long term," she explained. This technique ensures long-term stability and good esthetic outcomes.

Importance of three-dimensional biology

Dr. Groenendijk emphasized that both general dentists and dental technicians must have a good understanding of three-dimensional biology. Complications often arise from selecting inappropriate restorative components or applying excessive pressure on surrounding hard and soft tissues. An overly bulky emergence profile can lead to soft tissue recession, essentially undoing the surgical efforts. This underscores the need for careful planning and execution in both surgical and restorative phases.

How the Nobel Biocare N1™ System is innovating implantology

In response to these challenges, Dr. Groenendijk and her team have refined their approach to immediate implant placement and provisionalization. They now utilize the Nobel Biocare N1™ system, in combination with an N1 base, which enables a “one abutment, one time” protocol. This innovative approach allows general dentists to perform restorations at the tissue level, thereby minimizing complications and improving overall outcomes. Combined with the flapless procedure, this approach shows promising results in maintaining soft tissue integrity and promoting patient satisfaction.

Closing thoughts

Dr. Edith Groenendijk's work exemplifies the synergy between surgical expertise and prosthodontic precision in the field of implantology. Her research and clinical insights provide valuable guidance for dental professionals aiming to optimize immediate placement and immediate provisionalization outcomes. By adhering to realistic clinical conditions, meticulous implant positioning, and developing a thorough understanding of three-dimensional biology, practitioners can achieve long-lasting, esthetically pleasing results for their patients.