Rationale for immediate tooth replacement
Losing a tooth, especially one of our front teeth can be very distressing for most patients. In addition to the effect on appearance and confidence, it affects our speech and on the long-term, the gums and the supporting jawbone will also shrink. A common request from our patients is to get a replacement for their missing tooth immediately, hence the advent of protocols for "same day teeth replacement". This could be done by partially loading the implant on the day of the surgery, or more commonly by using the adjacent teeth as temporary supports.
How long does it take for healing after tooth extraction and implant surgery
Teeth extraction and implant surgery are fairly routine and painless procedures and you will feel back to normal in just a few days. However, it takes around three months after tooth extraction for the bone to reform before placing an implant. In addition, it takes a further three months for the bone to grow around the implant in order to anchor it firmly in the jaw. During this waiting period, removable dentures, or temporary bridges made of plastic are used to prevent direct forces on the implant allowing the implant to heal.
Can this waiting period be shortened
Yes, it is possible to reduce this waiting period as implants can often be placed immediately into extraction sites for patients with missing front teeth. This reduces the waiting times significantly. In general, we are able to place implants to replace our front teeth on the day of extraction as there is usually adequate bone around and beyond the tooth socket to stabilise the implant. For back teeth, it is not always possible as there is usually insufficient bone after removing the tooth. Very often a bone graft will also be needed and is therefore a more technique sensitive procedure.
Immediately Loaded Implants
If the implant lies firmly within bone, it is possible to even allow partial loading immediately after the surgery. In combination, with the latest computer assisted techniques, it is possible to deliver aesthetic looking temporary teeth in selected cases within 3 hours after the surgery. The patients are however advised to avoid chewing on the implant, especially in the initial weeks after the surgery when the original bone anchoring the implant would have been resorbed with the new bone yet to form.
Is immediate loading of implants a new technique
No, the first controlled study of successful immediate loaded implants was published in 1997 after a successful 10 year study. Our lead clinician has been placing immediately loaded implants since early 1999. The success rate of immediate implants are comparable to that of implants placed using conventional protocols but is more technique sensitive as it requires the dentist to determine if the initial stability of the implant is sufficient for immediate loading. Done selectively, it is a useful option for patients with no other remaining teeth to anchor a temporary denture or bridge.