Timing of Implant Placements: Immediate vs Delayed

In an ideal world, the dental implantation time frame would be minimised. While allowing the healing of the treatment area is necessary for a multitude of reasons, it’s normal for patients to be itching to show off their brand new smiles to the world.

Considering the nature of the treatment as a permanent solution compared to other dental prosthetics, the overall time and effort involved in the procedure is relatively extensive.

Immediate Implant Placement – What Is It?

Immediate dental implant placement is when an implantologist surgically extracts a tooth, before placing the implant fixture. The extraction and implant site heal simultaneously. If each procedure were to be completed individually, the collective recovery time would amount to 6 months. This comparatively quick healing turnaround makes this a favoured method by Marylebone Implant Centre patients.

However, this isn’t the most relevant upside of this treatment option to our implantologists. Over the past decade, the dental community has been comparing the best surgical approaches, primarily in the frontal mouth areas.

Nowadays, implantologists are inclined to perform minimally invasive procedures, i.e. procedures with no incisions or very small incisions. This favours the healing of the gum and bone, typically leading to an optimal outcome. By removing a tooth and immediately placing an implant in the socket of the tooth, little interference will occur, without incisions which leave scar tissue behind.

In these cases, we are often able to fit a fixed temporary crown or bridge supported by the newly-placed implants. This will facilitate the ideal healing of surrounding areas, giving patients optimal interim restoration while waiting for the implants to integrate.

Benefits of Immediate Placement

  • Quicker results: often in the same appointment that patients walk in to with a damaged tooth, they can leave having it extracted with an implant system configured. Additionally, patients may be candidates for the ‘tooth-in-a-day’ protocol, allowing them to have a temporary crown fitted upon a new implant screw.
  • Supports the retention of soft-tissue structure.
  • Superior aesthetics in the immediate term.

Disadvantages of Immediate Placement

  • Chewing can lead to implant failure.
  • Recession of gums surrounding the treatment area.
  • There’s a risk of bone volume decreasing through the healing process, which would compromise the implant-supporting structure and effectively lessen its weight-bearing ability.
  • Patients require a sufficient amount of soft tissue to qualify for the immediate procedure.

Delayed Implant Placement

The more traditional of the procedures, the delayed implant placement takes a two or three-stage approach, depending on whether a bone graft is required prior to implant placement.

First, the surgical extraction of the damaged tooth takes place. Following this, the patient waits for at least 3 months for the bone to heal properly, before further evaluations concerning bone volume and ideal placement areas can be made. At the conclusion of this stage, implant placement can occur; after which another 3 month recovery period is necessary prior to the fixation of the implant crown.

Usually, our implantologists follow the delayed approach if there is an acute infection on the specific tooth, if there is insufficient bone, or if the implant site is close to a vital structure, mostly concerning the posterior teeth (molars).

Delayed Placement: The Advantages

  • Due to the drawn-out healing time frame, the implantologist can better understand bone location and volume. This will enable more precise placement of implants. There is typically more bone available and this may decrease the need for a bone graft.

Delayed Placement: The Disadvantages

  • Two procedures = two periods of recovery.
  • A longer healing time overall.
  • The risk of infection developing within the periodontal membrane.

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