The removal of a tooth from the dental arch is called extraction. Extraction may be simple or surgical, depending on the site and condition of the tooth to be extracted. Extraction is the treatment option in case of non-restorable teeth caused by infection, caries, broken down roots, and trauma.
The extraction site will have detrimental effects. The bone remodeling in the area will cause a change in the size and width of the bone. Prosthetic replacement of missing teeth is done or proper maintenance of oral health, masticatory function, phonation, and esthetics and to prevent the tilting of adjacent teeth into the healing socket.
Most commonly used replacement options for missing teeth include a denture, bridge, and implants. Each replacement option depends on the site, time, and oral health of the patient and has its own pros and cons.
A dental implant is a long-lasting and durable solution for the replacement of missing teeth. Implants are the gold standard for the replacement of missing teeth. The implant screw is osseointegrated to the underlying bone, thus providing the best functional and esthetic rehabilitation.
The placement of dental implants is done through two approaches:
1. Staged approached.
2. Immediate Placement/Immediate Implant.
The Staged approach comprises two major surgeries on different visits. The treatment period is from 6 to 7 months, while the approach of immediate placement allows a faster treatment time, i.e. 3 months.
What is an Immediate Dental Implant?
An immediate dental implant is a tooth replacement option. An immediate dental implant is placed in the post-extraction socket right after the extraction on the same visit. The indications for an immediate implant are fractured tooth, loss of periodontal support, radicular caries, endodontic failure, and non-restorable teeth and crown.
Who is the ideal candidate?
Not all cases of extraction allow the placement of an immediate implant. The ideal candidate for an immediate implant is:
- The site is free from infection.
- Loss of one or more teeth.
- Has sufficient surrounding bone structure to support the implant.
- Has healthy periodontal tissues.
- Immediate implants are an excellent alternative to bridges because they don’t require altering adjacent teeth to fit.
Pros and Cons of Immediate dental implant placement:
The key advantages of immediate implants after tooth extraction are:
- Improved cosmetic results.
- Reduction in treatment time.
- Improved function.
- Bone maintenance – Prevents the loss of alveolar bone height and width.
There are some disadvantages to immediate implant placement. Not all extraction cases allow the placement of an immediate implant. Some cases need to go through healing before placing a prosthesis. Though immediate placement allows a relatively lesser loss of bone structure as a part of healing but it will not allow complete predictability of the future structure. Moreover, the patient will face a higher upfront cost, i.e. he or she will have to pay for both the procedures within the same visit.
In a 2 year follow-up, immediate implants give an overall success rate of 93.4%, while the conventional implant placement showed a success rate of 95.7%.
Simsek B, Simsek S. Evaluation of success rates of immediate and delayed implants after tooth extraction. Chin Med J (Engl). 2003 Aug;116(8):1216-9. PMID: 12935415.