What is immediate placement, and why would I want it?
So glad you asked! Immediate placement is when an implant is placed at the same time that the tooth is removed. This is the best time for the large majority of patients for several reasons.
- This is the most comfortable and convenient time. This requires only one appointment for both the extraction and the implant placement, so there is only one healing phase.
- There is generally less pain associated with immediate placement than with delayed or staged treatment. When a dental implant is placed into the socket of an extracted tooth, it requires much less site preparation and thus less trauma to the bone. The implant also fills the socket, so there is no open socket left to get food caught in and there is no chance of dry socket. Most patients are more comfortable after an extraction with an implant than with just the extraction.
- The over-all treatment time is greatly reduced. Because the implant is healing to the bone at the same time that the socket is healing in, the total healing time is generally half.
- This approach allows us to place a much larger implant that is more appropriate for the size of the tooth especially in molars. Because the bone has not resorbed while waiting for the socket to heal up, there is more bone to place the implant into. This allows an implant to be placed that fills the socket and matches the size of the tooth. In this way we avoid the typical “lollypop on a stick” look that is generally seen when large teeth, like molars, are placed onto narrow implants.
- Immediate placement is generally much simpler from a healing standpoint and is also generally less expensive. Because we have the maximum amount of bone available, we are much less likely to need to do bone grafting, thus reducing the cost. This is especially true with the molars of the upper jaw where the sinus is often in the way requiring large bone grafting procedures.
When can a tooth be put on an immediate implant?
In the esthetic zone (those areas visible when you smile), we generally put a temporary tooth onto the implant at the time of placement. You come in with a tooth or a space and leave with a tooth. This does require that the patient be careful not to chew on the tooth during the healing phase. For molars and other teeth outside of the esthetic zone we do not recommend a temporary tooth be placed because a back tooth you cannot chew on is just in the way.
Is it actually easier to place an implant immediately?
No. It is much easier for the patient, but these are advanced techniques that require special training and guidance systems to control the path of the implant. Poor technique or lack of understanding can easily destroy the socket rather than use and preserve it. This is not the realm of the beginner.
Is it more successful to wait until after healing to place the implant?
No. Years of experience with these techniques and several published studies demonstrate that the over-all success rate of immediate placed implants is at least as good as and often better than those that wait to heal. The more appropriate size of implant is also a potential long term advantage of the immediate placement approach.
Why would I want to have my tooth extracted and wait to have an implant placed at a later time?
I have no idea