Immediate implantation (not to be confused with immediate loading) means that a tooth is extracted and replaced immediately with an implant in the same session. This spares the patient an additional operation and is a standard procedure today. However, sometimes, e.g. in the case of infected teeth, it is better to remove the tooth first and wait until the inflammation in the bone has subsided before placing the implant.
Immediate loading of implants
As described above, implant treatment traditionally consisted of several successive phases:
- Extracting the tooth
- Placing the implant
- Healing phase (6 weeks to 6 months)
- Uncovering the implant
- Installing the permanent crown, bridge or dentures
The long waiting time before completion of the final permanent restoration can be a problem, particularly if a satisfactory fixed provisional restoration cannot be fitted. In the case of major full-mouth reconstruction with implants, which involves removing all the teeth and replacing them with implants, the patients often had to wear full dentures for months until the implants had integrated and could be loaded.
In such cases, immediate loading of the dental implants can be particularly advantageous. In a single session (also under general anaesthesia), all teeth are removed, the implants placed and a provisional fixed bridge prepared which is screwed onto the implants some hours after the operation. This procedure offers a great gain in comfort and time for the patient. However, it is important to emphasise that immediate loading is only feasible if there is a sufficient bone mass and bone quality to ensure stable anchoring of the implants. If this is not the case, it is always advisable to leave the implants to integrate without loading and only install the restoration when this has taken place.
Example I from our practice
54-year-old patient with severely compromised dentition. Periodontal gum disease and dental decay had led to such serious damage that it was no longer possible to save the teeth. The patient had suffered considerably from her cosmetic "disfigurement" and expressed a wish for full-mouth reconstruction under general anaesthesia with "permanent teeth" from the very beginning. It was important to her that she remained aesthetically presentable throughout the entire treatment period.
Under general anaesthesia all teeth in the upper and lower jaws were removed. In the same session we placed 4 implants per jaw. The All-On-4 method allows such stable anchoring of the implants in the bone that fixed, functional bridges can be installed immediately. On the same day, 4 hours after the operation the patient was fitted with fixed provisional bridges screwed onto the implants and was able to return to her home town. The definitive bridges were then fitted three months after the beginning of treatment.
Chapter overview: Implants
- What is an implant?
- Single-tooth implant
- Implants in the toothless jaw
- Bone augmentation
- New surgical procedures
- Immediate implants
- Risks and complications of dental implants
- Costs an guarantee of implant treatment
- Questions and answers about dental implants
Download the entire illustrated text Better Quality of Life with Dental Implants:
Better Quality of Life with Dental Implants (pdf 2 MB, possibly long download time)