Are Immediate Implants For Me?

Some doctors advocate immediate implant placement and immediately-loaded implants as a predictable and successful option for tooth replacement. Although many patients have had success with immediate implants and immediate tooth replacement, I wanted to clarify a few tings about the definitions and real-world success.

An implant is a titanium screw that is placed in the jawbone. An implant serves as a platform on which a replacement tooth (called a restoration) can be connected. A tooth replacement requires both an implant and an implant crown restoration, or in some cases, an implant-supported denture restoration.

An implant can have primary stability in the bone, which is where the threads of the implant screw are wound tightly within bone, much like a wood screw in a 2x4. Primary stability can be immediate. Implant success is truly based on how it integrates with the bone. Integration requires months to develop. Osseointegration is a growth of bone along the implant surface. This happens even if primary stability is not achieved.

Implants placed immediately after a tooth is removed require both primary stability and a healing period for osseointegration. Without good integration, there is a risk that the implant will fail when the restoration is placed on the implant.

The implant surgeon must manage how the restoration works with the bite. If the implant and the restoration is immediately loaded, that means the implant is subject to the pressures and forces of biting. And without good integration and stability, The chances of premature implant failure are higher.

So it is difficult to predict how immediately placed and immediately loaded implants will do over the long term unless the implant surgeon allows for uninterrupted osseointegration. My real-world experience has shown that implants loaded too early can fail.

There are a wide variety of factors that come into play about how and when an implant can fail--medical conditions, tobacco use, periodontal disease, biting forces, the list goes on--but I have come to realize that the best approach to placing and restoring implants is to be patient and allow for integration. Then the final results will likely be predictable and long-lasting.