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Dental implants are today's state-of-the-art tooth replacement systems. However, the traditional procedure can take up to one year. Nowadays, same day dental implants are becoming far more common: tooth removal, implant placement, and crown attachment are all performed during the same visit. But are immediate implants a viable solution? Check out the risks and benefits of same day dental implants vs traditional implants.

Same day dental implants

author icon By Dr. George Ghidrai

Dental implants have many benefits. One of the most important is replacing a broken or damaged tooth in the front area that can no longer be restored.

damaged tooth

broken front tooth that can no longer be restored

In this case, an implant crown offers a highly aesthetic and efficient solution as it avoids the need to prepare the adjacent teeth.

same day dental implant

after tooth removal, a dental implant is placed to restore the gap


However, the traditional procedure can take up to one year as it implies three different steps:

  1. Removal of the existing tooth or root. The extraction socket is left to heal for four to six months before a dental implant is placed. During this period, the body will grow new bone inside the socket.

  2. The implant is surgically inserted into the jaw bone. A variable amount of healing time is required for osseointegration (3 to 6 months). Osseointegration is a biologic process where the implant forms an intimate bond to the bone.

  3. After the healing time, a dental crown is attached to the implant.

Teeth in a day: Immediate placement and loading

Patient demand for immediate gratification has increased; as a result, implant dentistry has since responded with immediate implant placement after extraction followed by immediate loading of the crown.

Nowadays immediate loading is becoming far more common: the implant and temporary crown are placed within 48 hours of implant surgery and are left in position for the healing period.


Who is a candidate for immediate tooth replacement with implants ?

Immediate placement is not appropriate for all patients and cases and the screening process should be extremely thorough. The ideal candidate is someone who is in good dental and general health. Some factors can also negatively affect dental implants:

Patients who choose this approach must also be committed to good oral hygiene. Furthermore, not overloading the implant crown is another factor that needs to be reinforced with patients when loading an implant immediately after placement.

Patients with enough bone quantity and quality are great candidates for immediate placement and loading because of anticipated implant initial stability assuming that they would be compliant with postoperative instructions.


Procedure steps

There are a number of issues and steps to consider:

1. Consultation and planning

Dental implant surgery has to be meticulously planned; when you opt for immediate implant placement, careful planning and experience are prerequisites for success.

Your dentist will need to know your complete dental and medical history before carrying out various diagnostic tests, such as dental x-rays and a CT scan.

The data from these tests must be analyzed to assess the quality of the bone that will be surrounding the dental implant. When an implant is placed into a recent extraction site, many doctors prefer to graft bone in the alveolar socket to create a bony base for the implant.

There should also be enough gum tissue to surround the implant and crown as this will affect aesthetics; the implant crown should look as if it is emerging naturally from the gums. Gum tissue can be grafted from another site in the mouth if necessary.

At this stage, the dentist will also determine the best position for the implant and will choose the correct size.

2. Removing the existing tooth

It is quite critical that your broken tooth is removed very carefully so that the tooth socket is not damaged.

If any bone from the walls of the socket is damaged or lost, it could lead to unsightly gum recession and/or a poor prognosis; in this case, many practitioners would prefer to end the procedure (and continue with the traditional approach) rather than risk a poor result.

3. Implant placement

Using this technique, the implant fixture is placed in the bone right after the tooth extraction.

It is vital to place the implant so that it is stable and non-movable in the bone. This stability is referred to as the primary stability of the implant.

Latest research suggests that the primary stability of the implant in bone is a more important determinant of the success of implant integration, rather than a certain period of healing time.

The tooth socket of an upper front tooth is cone-shaped. To achieve primary stability, the implant has to penetrate the apex of the socket (or the end point) and affix to the bone in this area (see image below). Additionally, a bone graft can be placed inside the tooth socket.

immediate implant placement for a front tooth

It is very important to select the right-sized implant for the situation and make sure that it is placed in exactly the right position.

4. Crown placement

The crown will be attached to the implant in one of two ways:

Regardless of the variation used, it is critical that the newly attached crown is free from biting forces, which could displace the implant. The crown is usually a temporary crown, made of a composite or acrylic resin, which can easily be modified to ensure that it is both functional and cosmetic.

Once the implant is fully integrated with the bone, the temporary crown can be removed and replaced with a permanent one.

5. Care and maintenance

Immediate implant placement and loading requires higher patient compliance. There are 3 key factors that patients have to consider:


Benefits and risks of same day dental implants

Benefits


Risks and drawbacks


Conclusions

First of all, it is very important that patients understand the risks, benefits, and alternatives regarding single tooth implant placement and timing. Same day implants can only be used in specific situations and patients need to be carefully evaluated for their suitability.

Preplanning and experience from the implant surgeon as well as thoroughly conducted care measures are required for the success of this technique. If you are not suitable for immediate dental implants placement, it is still worth considering delayed loading implants, even though treatment will take a little longer.


References

American Academy of Implant Dentistry:

Dear Doctor, A Patient Education Company:

The National Center for Biotechnology Information:

Last review and update: May 2018



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