Dental implants are used extensively for replacing missing teeth. In ground breaking conventions late 20th century, the cylindrical symmetrical screw(fixture) is accepted as the product design of choice. Ever since it must be seen as a compromise solution. Crucial for implant-placement is sufficient bone volume. In the widely used delayed procedures, a healing time of the bone (avg. 2-3 months) has to be accepted, after extraction of the tooth. When the implant is placed it will take another 6-8 weeks months for osseointegration (bone healing). The restoration is placed 5-7 months after extraction.
If a patient has insufficient bone volume to insert an implant, bone augmentation surgery is indicated. Bone augmentation are adding more surgical interventions and thus extra healing time is involved.
Bone augmentation includes a variety of procedures, such as sinus lifts, vertical and horizontal bone grafting procedures, the use of autologous or bone substitutes, membranes and manipulation of bone using an osteotome. The implant can only be placed with predictable success after the bone augmentation procedure is completed. The time to restoration will be extended to 12-18 months after extraction.
Over the last decade, immediate replacement of a compromised tooth – extraction and inserting an implant in 1 surgical session – has proven to be an effective strategy with excellent clinical results. The implant is placed in the fresh extraction site. The challenge in this procedure is to achieve sufficient primary implant stability as the regular symmetrical cylindrical screw implants are not designed for immediate implantation.
Immediate tooth replacement satisfies patients’ expectations as it reduces the time to the final restoration by less surgical interventions, clinic visits and reduced total cost of treatment.