Abstract
Immediate implant placement can reduce treatment time and support preservation of the existing alveolar architecture. However, maintaining interdental papillae and peri-implant soft tissue stability remains an important challenge, particularly in the aesthetic zone. Atraumatic extraction, effective socket debridement and management of the early healing environment are therefore important considerations in achieving favourable aesthetic and biological outcomes.
This clinical case series presents three cases of immediate implant placement incorporating a dual-wavelength laser protocol aimed at supporting extraction socket debridement and disinfection, soft tissue preservation and post-operative healing.
Following atraumatic tooth extraction, the sockets were debrided and disinfected using a 2940 nm Er:YAG laser at 3 W. Laser-assisted debridement was used to remove residual granulation tissue and decontaminate the extraction socket while minimising mechanical trauma to the surrounding hard and soft tissues. Immediate implant placement was subsequently performed with particular attention to preservation of the existing gingival architecture and interdental papillae.
Following implant placement, photobiomodulation (PBM) was performed using a 650 nm laser at 100 mW for 40 seconds. The PBM protocol consisted of three treatment sessions at three-day intervals, with the aim of supporting early tissue healing and modulating the post-operative inflammatory response.
Clinical and photographic follow-up across the three cases showed favourable healing with maintenance of the interdental papillae and peri-implant soft tissue architecture.
This case series illustrates the potential role of combining Er:YAG laser-assisted socket debridement and disinfection with post-operative photobiomodulation as adjuncts to a tissue-preserving immediate implant protocol. Further controlled clinical studies with standardised soft tissue measurements are required to evaluate their contribution to long-term peri-implant tissue stability and aesthetic outcomes.
Learning Objectives
- Discuss the biological and clinical factors influencing interdental papilla preservation and peri-implant soft tissue stability following immediate implant placement.
- Explain the principles and clinical rationale for using a 2940 nm Er:YAG laser for extraction socket debridement and disinfection.
- Demonstrate a tissue-preserving clinical workflow integrating atraumatic extraction, laser-assisted socket management and immediate implant placement.
- Describe the biological principles of photobiomodulation and its potential role in modulating inflammation and supporting early peri-implant soft tissue healing.
- Explain the clinical application of a 650 nm photobiomodulation protocol following immediate implant placement, including treatment parameters and timing.
- Evaluate the clinical soft tissue and interdental papilla outcomes demonstrated across three immediate implant cases.
- Discuss the potential benefits, limitations and current evidence considerations when integrating Er:YAG socket treatment and photobiomodulation into immediate implant protocols.
