Same-day tooth extraction, same-day dental implants

close-up-process-dental-implants-teeth-health-care

Written by Dr Amrita Jain

September 29, 2021

In recent years, dental implants are proving to be the most preferred treatment choice for replacing missing teeth. People are choosing dental implants over any other teeth replacement options. And why not? Implants have more benefits to offer over a denture or a bridge. Studies have proved dental implants as the most successful treatment option for missing teeth.

Traditional implants take anywhere between 4-6 months to complete the entire procedure. Back in the 1990s, implants were placed only after the complete healing of the tissues post tooth removal. But with immediate implants, there is no more waiting to replace your missing tooth. Nowadays, advanced clinical techniques, new biomaterials, and skilled dentists have made it possible to place implants immediately once the diseased tooth is removed.

Bone loss with traditional implants

Conventionally, dental implants were placed 6 months after the tooth extraction to allow complete healing of the extraction socket. But with this way of placing an implant after having your tooth removed the alveolar bone loss (loss of jaw bone) was documented to be about 4mm in bone height and almost 25% loss of bone density. Dentists could not afford this percentage of bone loss, as placing an implant needs good bone density.

Furthermore, in 3 years post-extraction, a massive 40-60%bone loss was documented. Researchers reported that approximately 6mm bone loss was identified in 6-12 months, 50% horizontal bone loss while 2-4 mm vertical ridge loss was documented. This means the percentage of bone loss kept increasing. Now, there are many other reasons and other factors too, that affect bone loss like the systemic health of the patient (diabetes, heart conditions, etc) underlying medical conditions, habits, traumatic extractions, periodontitis, number of adjacent teeth removed, gum health, type of prosthesis if present etc. 

Placing traditional implants

After a waiting period of 6 months post extraction, a two-step implant surgery is planned. In the first step, the implant screw is placed inside the bone and a waiting period of 3-6 months is indicated. This waiting period allows the fusion of the implant screw to the bone (osseointegration). This healing period is similar to the healing of the bone after any fracture in the body. New bone starts forming around the implant to make it more stable inside the bone. In the second step, the implant is opened to fix the artificial tooth on it. And there you are! A brand new tooth to replace your missing tooth.

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Now what are Immediate implants?

In order to reduce the waiting period of 3-4 months and avoid bone loss, immediate placement of implants into the extraction socket proved to be more beneficial and also proved to give a better success rate than traditional implants.

To replace your tooth immediately with implants your dentist will make sure the socket in which the tooth was present is absolutely healthy and infection-free. Your dentist also considers the health of the gums before placing an implant immediately into the socket.

How does your dentist decide?

It does depend on the amount of infection present and the damage to the surrounding tissues. Your dentist will study the parameters and then decide how long would you need to wait to replace your missing tooth with an implant.

Immediate implants– Immediate placement at the same time after extraction. Your dentist will mostly decide to go for same-day extraction same-day implants provided the mouth is absolutely free of any gum or bone infections.

Early implants– Implant placement after 2-4 weeks, which allows healing of the surrounding soft tissues. Your dentist will mostly want to wait for a period of 2-4 weeks in case there is a mild to moderate amount of gum or bone infection present. Your dentist also studies the rate of healing of the surrounding tissues in the mouth.

Delayed implants– 4-6 months after complete healing. Your dentist will not be able to place an immediate implant in cases where there is severe gum or bone infection present. The treatment procedure will not be successful unless there is complete healing of the tissues and elimination of the infections present in the mouth.

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Behind the scenes

For the long-term success of immediate implants, your dentist gets a thorough diagnosis and meticulously plans a detailed treatment plan. For a higher success rate of the treatment, your dentist studies the entire medical and dental history, clinical photographs, and study models of your teeth and jaw, and the bone conditions via x-rays and scans.

Are you eligible for immediate implants?

While the immediate placement of the implant in a fresh extraction site has proved to be a predictable treatment option, there are certain challenges that continue to question the treatment modality. Although, immediate placement of an implant at the time of extraction of a hopeless tooth is desirable, there are certain factors that a clinician has to consider while planning an immediate implant.

  • Good bone quality, quantity and density
  • Health of the tissues in the mouth
  • The ability of an implant to achieve primary stability.
  • Gum health
  • Aesthetics and level of smile line.
  • Facial bone wall.
  • Sufficient bone height.

An intact full facial bone with thick gingival biotype presents a favorable condition with low risk of gingival recession and implant exposure.

Non-vital teeth fractured at the gingival margin wherein the roots are shorter than 13mm, is the ideal choice for immediate implant placement.

Unfortunately, you can’t go for it, if

  • If you have a high smile line.
  • Any gum or bone infections are present.
  • You have a thin gum line
  • Underlying medical conditions that may complicate the process.
  • You are a heavy smoker.
  • Uncontrolled gum and bone diseases (periodontitis).
  • There is an absence of intact facial bone.
  • Maxillary sinus involvement.
  • Suffering from any parafunctional habits.
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Given a choice, go for immediate

For over 40 years now, dental implants are the preferred treatment option for replacing a missing tooth over fixed and removable prosthesis like dentures or bridges. The results achieved with implants are not only successful, but aesthetically pleasing and predictable, and comfortable too. With proper diagnosis and treatment planning, immediate implants reap many benefits. To highlight, some of the advantages of immediate implants are

  • Shorter treatment time.
  • Simplified surgical workflow.
  • One step surgery.
  • Better patient satisfaction and treatment acceptance.
  • Preservation of soft tissue morphology.
  • Reduced patient discomfort and pain.
  • Avoids loss of gum tissue during surgery
  • Prevents early bone loss

Highlights

  • In recent times, due to the fast-paced lifestyle, immediate implant has become the most popular treatment option.
  • There is an emerging trend and demand for immediate implants due to its numerous benefits.
  • Immediate implants is the best option if you do not to pull a single day with a missing tooth.
  • Not all missing tooth cases can be treated with immediate implants. Your dentist will decide what is best for you.
  • In some cases, lasers can be used to get rid of all the infections and infected gum tissue and bone to place an immediate implant. But this too depends on the case and is for your dental surgeon to decide.
  • Maintaining a good oral hygiene will improve the success rate of the treatment.

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Dr. Amrita Jain is a practicing dental surgeon since 4 years. She completed her B.D.S in 2016 and was has been a rank holder throughout her course. She suggests “Holistic dentistry is the best dentistry”. Her treatment line follows a conservative pattern which means saving a tooth is of utmost priority and preventing your teeth from getting decayed rather than curing it with a root canal treatment. She inculcates the same while consulting her patients. Apart from her interest in clinical practice, she has developed interest in research and writing over a period of time. She states “It is my clinical experience that motivates me to write and spread dental awareness”. Her articles are well researched with a combination of technical knowledge and clinical experience.
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