Immediate implant placement is when a dental implant is placed in the bone at the same time after extraction of the natural tooth.
It involves the placement of a prosthetic restoration within 48 hours of implant placement. It can be implemented only if sufficient primary stability is achieved – for a single tooth or two or multiple missing teeth restoration, this is known as provisionalization.
The technique was developed to meet the patients’ growing demand for quicker treatment and faster “time-to-teeth”. Several long-term studies have performed since then with 5-10 years’ follow-up, high cumulative survival rates, such as around 97% – 100% were reported for immediately loaded implants placed in extraction sites for any indication. To avoid loading a restoration, the provisional should be taken out of occlusion or the patient should be instructed to follow a soft diet.
In suitable cases, immediate placement and immediate loading offer an array of benefits for the patient, including shorter treatment time and significantly reduced time (if any) spent with a gap in the dentition since the esthetic restorations are provided on the day of surgery. It may therefore offer a suitable solution for high patient satisfaction, when clinically indicated.
Immediate implant placement and provisionalization have been used with good predictability in clinical practice. Immediate loading reduces the need for surgical intervention and complex bone grafting procedures that might otherwise be required to restore resorbed ridges. The one-stage technique offers a simplified surgical workflow and subjects the patient to one surgery instead of two. Improvements in patients’ post-operative experience following flapless approaches for single-tooth rehabilitation have been reported. Successful cases of the immediate loading protocol have also been reported for multiple implant placement.
With close collaboration between oral surgeon, prosthodontist and lab technician, immediate implant placement and immediate loading can provide a unique selling proposition (USP). This can form an integral part of a marketing strategy, ensuring the practice is more attractive than others in the local vicinity, or even further afield.