Dr. Michael’s Dental Clinic’s Oral Maxillofacial Surgeon Dr. Walter Goriwoda, MD, DMD answers the most commonly asked questions about immediately-loaded dental implants.
What are immediately loaded implants? Are same day implants the same as immediately loaded implants?
In modern dentistry, missing teeth should be ideally restored by insertion of dental implants. In many cases and specifically in the aesthetic regions, where patient would show gaps after tooth extraction, a single dental implant can be placed immediately after tooth extraction into the fresh extraction socket. In most cases, the implant is stable enough to be loaded with an immediate implant crown. To allow for osseointegration of the implant, the surrounding bone has to grow right onto the implants surface without being disturbed by any movements of the implant. This is why the immediate crown on a newly inserted single dental single implant should not be subjected to any masticatory forces for several weeks.
In cases where rehabilitation of all teeth in upper or lower jaws is necessary, at least 4 implants (better more) should be inserted into one jaw. The whole dentition can then be attached to these implants as a suprastructure. Due to different biomechanics, minor masticatory (chewing) forces can be tolerated immediately.
The term same day implants is mainly used for advertising purposes, but indeed comprises immediate loading of the newly placed dental implant.
Who are the best candidates for immediately loaded implants?
Ideally the best candidates are young, healthy, nonsmoking patients without any periodontal disease and sufficient amount of bone, which of course is almost never the case! There is always a specific reason for the necessity to remove a tooth/teeth and each case has to be investigated individually for the suitability of extraction with immediate implant placement and loading. In general, there is very few absolute contraindications.
What are the benefits of immediately loaded implants?
Following a conservative treatment modality means to wait 3-6 months after tooth extraction. Then the implant is placed and another 3 months for osseointegration are awaited before the restoration with a crown takes place. This is an almost unacceptable long period of time for our modern society! But more importantly, another negative side effect might occur during this waiting periods which is resorption of bone and recession of gums.
Insertion of a dental implant right after tooth extraction with immediate placement of a crown has a superior outcome when it comes to the long term aesthetics of the surrounding tissues. The alveolar bone surrounding the newly placed immediately restored implant and its surrounding gums will be preserved to its maximum degree. It should be the treatment modality of choice for aesthetic areas where the patient shows gums when smiling!
And of course it is a nice side effect for the patient to get a complete dental rehabilitation in a day and not to suffer from a socially unacceptable tooth gap for several months neither to struggle with some temporary removable denture.
What is the success rate of immediately loaded implants?
The success rates of extraction with immediate implant placement and immediate loading of primary stable implants do not differ from the conservative treatment modality, when the suitability is clinically assessed prior to surgery. Prognosis can be compromised due to periodontal disease, insufficient oral hygiene, or systemic disease but then all dental surgical procedures are more prone to complications independent of which implant insertion concept was followed.
What is the procedure like? How many appointments will it take to get the implants and crowns done?
The removal of the tooth is the more invasive surgical part. Inserting the dental implant into the fresh extraction socket is easily practicable. In most cases the implant is stable enough in the anterior jaw and can be immediately restored with a chairside custom made temporary crown. The whole procedure of dental rehabilitation is done in one session only and takes approximately 2 hours.
What can patients expect after receiving their implants?
Depending on each patient individually and the location of extraction and implant placement, some amount of swelling and pain, must be expected for about 3-5 days and even bruising might occur.
How often should patients come to visit their oral surgeon after the implants are done?
It is advisable to have a follow-up with the surgeon approximately a week after implant placement and again prior to restoration with the permanent crown. In the long term, the implant maintenance constitutes of regular sessions with the dental hygienist and normal follow-ups with the dentist.