Immediate Dental Implants

Your surgeon will insert the implant post directly into the jawbone using this surgical guide. The actual surgery to insert the post is quite quick and can often be carried out under a local anesthetic. If you require several dental implants or are particularly nervous then it is worth asking about extra sedation. Your replacement tooth or teeth will be attached to the dental implant soon after surgery is completed.

Benefits

The healing cap “shapes” the soft tissue surrounding the implant, preparing the site for the permanent crown.

• Reduced treatment time. Able to replace a front tooth almost immediately. Traditional implants often take between three and six months to completely restore. As a result, many people will opt for faster but less effective methods of tooth replacement such as a dental bridge, and will miss out on the advantages offered by dental implants including preserving jawbone density.
• Only one surgical procedure is required. The implant, abutment and temporary crown are placed during the same procedure, greatly reducing overall treatment time. There is no need to uncover the implant 3-6 months later in order to add the abutment and crown.
• Gum tissue matches up with the crown better. Traditionally, cylindrical healing caps (see right) may be placed on top of the newly inserted dental implants to shape the gum tissue. With immediate loading, the gum tissue can be shaped by the temporary crown (which is more similar in shape to the permanent crown) so the gum tissue matches the permanent crown and better aesthetic results are achieved.
• Avoid temporary dentures or the “missing teeth” look. Immediate load dental implants reduce the psychological and physical impact of losing teeth by quickly replacing them so there is no need to wear a removable prosthesis such as a denture or have gaps in your smile during the healing period.

Risks

• Even the smallest movement increases the risk of failure. Immediate loading is a very precise technique and the surgeon does need to take precautions to ensure the implant cannot move while integrating with the bone.
• The technique is only suitable in specific situations. The implant has to be placed in strong bone and must be able to withstand 35 Ncm of torque. It works best for front teeth that have strong, healthy teeth on both sides. It is also successful for replacing all the teeth in the lower jaw where the bone is strong and dense. Immediate loading does not work well for replacing all teeth in the upper jaw as the bone tends to be less dense and is rarely strong enough.
• All implant surgery carries a small percentage of risk. There are a number of factors that can cause problems. Implant failure can occur in the short-term if the implant fails to integrate with the jawbone or the surrounding gum tissue becomes infected. The risk of infection remains in the longer term, and there is always the possibility of mechanical failure if the implant is subjected to excessive stress or force.

Alternatives

It is important to take good care of the area around the implant for the first couple of months after the surgery in order to prevent infection and to make sure the implant isn’t exposed to too much force or pressure.

If maintaining this level of care could be a problem, then you should consider traditional dental implants that use a two stage technique. First, the implant is placed in the jawbone and allowed to heal for several months during this time it is covered and protected from the elements by gum tissue. A second surgery is then required to uncover the implant and attach the abutment and crown.

Who is a Candidate?

The screening process is extremely thorough. The ideal candidate is someone who is in good dental and general health. You may not be suitable for treatment if you smoke, have any conditions that affect your immune system or reduce the body’s ability to heal, or if you have been prescribed high doses of bisphosphonate drugs. This is because these drugs increase the risk of bone death after even minor surgery, particularly if they have been given intravenously as part of therapy for cancer. People who have been given low doses of bisphosphonates, for example for osteoporosis, are not at any higher risk for bone death.

Bruxism or teeth grinding and clenching can also negatively affect dental implants, through placing too much stress on the implant crown and post. Patients who choose dental implants must be committed to good oral hygiene, as otherwise there is a chance the tissue surrounding the post could become infected with a condition similar to gum disease, and which is called peri-implantitis. This condition can result in implant failure if not promptly treated.

Same Day vs Early vs Delayed Loading – Success Rates

Once an implant is placed, it is important that new bone cells grow on and around the implant post so it bonds with the jawbone and is held firmly and permanently in position. It was previously thought that loading the implant during this healing period would increase the chances of failure, and that the implant post needed to be left to heal for between three and six months to ensure long-term success.

However has found the initial stability of the post is more important in determining the success of the implant. The initial stability is determined by the density of the bone, the force applied to place the implant and the number of implants that are splinted together. The conclusion of this research is that there is no significant difference between the successes of implants that are loaded immediately compared to those left to heal for several months.

That said, single dental implants should be given a period of no-load, to minimize the risk of micro-movement and failure. This is why immediate loading for a single implant is often only offered for front teeth – the temporary crown can be kept completely out of contact with other teeth during the healing period.

Conclusion

Same day dental implants can be useful in specific situations, but patients need to be carefully evaluated for their suitability. It is also important that the implant surgeon has sufficient skills and experience to accurately place the dental implants so the risk of any micro-movements is eliminated. If you are not suitable for immediate load dental implants, it is still worth considering delayed loading implants, even though treatment will take a little longer.