Friday, November 27, 2009

Immediate Implant Placement and Immediate Implant Loading

Immediate Loading is a hot topic in implant dentistry.

This means you will have a tooth placed on your dental implant within 24 -48 hours of surgery.

Here is an example of the entire lower jaw replaced with nine implants and an immediate bridge:

Every patient that I treat has always wants his or her teeth right away. You really need weigh the risks versus benefits of this particular procedure.

Immediate teeth work best for teeth in the front of the mouth. It also works very well if you are missing all your teeth and is most successful if you are having several implants placed for your whole  jaw. When the dental implants are put in,  a temporary tooth or whole set of teeth are made right on the spot or have been made prior to surgery by a lab technician. You would walk out of the office with teeth not gaps. The temporary teeth  look, feel and work like your regular teeth.

You have an important role in the success of this amazing procedure. I will tell you, that you have to be committed to a soft diet for about 3 months. Even though a tooth is made on the immediate, same day implant, it still has to fuse to your bone. This is called "osseointegration." If you can’t commit yourself to this, immediate loading or immediate temporaries are not for you. It has a high risk of failure if you chew harder foods too early. All of the implants can fail.

If it were just one tooth, like your front and center upper tooth,  the immediate temporary is made so it doesn’t touch the bottom teeth. This further prevents the chance of using the tooth too early.

Some of the important factors in determining if immediate loading can be done are:

•Bone density

•Amount of bone

•Initial stability of the implants

•Shape and type of gum

•Implant design and type

•Your bite

What's the race to get a tooth today? I am all for immediate dental implants when it does not pose a significant risk of failure to you. If the procedure will be just as successful to have the immediate implant, as it is the traditional "delayed" approach, then you should strongly consider it. It may even reduce the total cost, too and saves time.

I have a wealth of experience in this procedure and let me tell you this is not for the novice implant surgeon or dentist. One tiny error can yield disastrous results.

The next level up is an immediate implant with a temporary on the same day the tooth is extracted! This is an extremely common procedure I have been performing  in my office for several years. I most commonly do this for front or side teeth. If there is infection, it may not be an option for you. Sometimes the infection dissolves the really thin bone on the outside surface. If this is the case, an immediate dental implant is not recommended.

A bone graft is sometimes necessary with immediate load dental implants and can be done at the same appointment. Every situation is very different.

With any situation you should have a back up plan. In my opinion, this procedure is a bit "over-marketed" as a solution for everyone, but it really only accounts for about 5-15% of situations. There are times that immediate implants are planned, but during the surgery I find that the bone or implant is not strong enough and I have to abort and not put the implants in that day.

The bottom line.... immediate dental implants are great in the perfect situation. Pre-surgical planning and expert execution of the procedure makes all the difference

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