Immediate Dental Implants...Things To Consider

"Immediate loading" is a hot topic in implant dentistry.

In its most basic definition, it means you will have a tooth on your dental implant within 24 -48 hours of surgery.

Here is an example of the entire lower jaw replaced with nine implants and an immediate bridge:

Every patient that I have treated has always wanted his or her teeth right away. You really should weigh the risks versus benefits of this procedure.

Immediate teeth work best for teeth in the front of the mouth.  It also works very well if you are missing all your teeth and is most successful if you are having implants for your whole lower jaw.  When the dental implants are put in, I would make a temporary tooth or whole set of teeth right on the spot.  You would walk out of my office with teeth not gaps. The temporary teeth will look, feel and work like your regular teeth.

You have a big role in the success of this awesome procedure.  I will tell you, that you have to be committed to a soft diet for about 3 months. Even though a tooth is made on the immediate, same day implant, it still has to fuse to your bone. This is called "osseointegration."  If you can’t commit yourself to this, immediate loading or immediate temporaries are not for you. It has a high risk of failure if you chew harder foods too early. All of the implants can fail.

If it were just one tooth, like your front and center upper tooth, I would make the immediate temporary so it doesn’t touch the bottom teeth. This further prevents the chance of using the tooth too early.

Some of the important factors in determining if immediate loading can be done are:

• Bone density
• Amount of bone
• Initial stability of the implants
• Shape and type of gum
• Implant design and type
• Your bite

What's the race to get a tooth today? I am all for immediate dental implants when it does not pose a significant risk of failure to you.  Meaning if it is just as successful to have the immediate implant, as it is the traditional "delayed" approach, then you should strongly consider it. It may even reduce the total cost, too and saves time.

I have a lot of experience in this and let me tell you this is not for the novice implant dentist. One tiny error can yield disastrous results.

The next level up is an immediate implant with a temporary on the same day the tooth is extracted! This is a very common procedure I perform in my office in Burbank, California for the last 10 years.  I most commonly do this for front or side teeth.  If there is infection, it may not be an option for you.  Sometimes the infection dissolves the really thin bone on the outside surface. If this is the case, an immediate dental implant is not recommended.

Here is an example case of a front tooth immediate dental implant. 

A bone graft is sometimes necessary with immediate load dental implants and can be done at the same appointment. Every situation is so different.

With any situation you should have a back up plan.  In my opinion, this procedure is a bit "over-marketed" as a solution for everyone, but it really only accounts for about 5-15% of situations.  There are times that immediate implants are planned, but during the surgery I find that the bone or implant is not strong enough and I have to abort and not put the implants in that day.

I always have a back up temporary tooth ready just in case!

Bottom line.... immediate dental implants are great in the perfect situation. Pre-surgical planning and expert execution of the procedure makes all the difference.

Please feel free to ask questions and comment below!

Comments

[June Swinerton]

my endodontist almost refused to tell me what risk were involved in implants. I had front tooth root canal failure (was also crowned) and he immediately suggested implants- i mentioned retreatment- he claimed he had a 80 percent success rate. During the procedure I felt all was good, as soon as he was done he said the tooth was cracked. I heard it crack during the proceedure and it wasn't on the first x-ray, now I am forced to do an implant and wasted 400 dollars for the attempted retreatment. I am not rich. I did have some bone loss- tooth number 8. I am apprehensive about an implant and got no information of the risk. What options do i have and what is a mini implant. the other front tooth was also crowned so I was wonderting about the bridge option too. I was told to go one type of specialist for the one solution, and another for a bridge- but I cant keep running around spending money (120) each just to talk about information. I found much on the internet and the dentist I have talked to have not supplied me with. I need to make a fully informed decision. Any help (even websites explaining risk) would help. June

[Dr. Ramsey Amin]

Hi June,
Sorry for the delayed reply. My computer hard drive crashed!

Unfortunately, each situation is VERY unique. I suggest you get in touch with an expert implant dentist. Use the link in the upper right to find someone who is certified by the American Board of Oral Implantology.

Do you have any x-rays you can post?

[ADAM JELONEK]

Is therapy with PLAVIX contraindication to titanium implants?

[Dr. Ramsey Amin]

I actually wrote an article about this here:
http://www.dentalimplantdentistryblog.com/2009/04/blood-thinners-and-dental-implants.html

Does this help?