On immediate implant placement — a column by the director of The Reborn Dental Clinic

Immediate placement means exactly what it says: extraction and implant placement carried out at the same time. Rather than waiting for the gum to heal, both are completed under one anaesthetic. Some patients worry about how an implant can go in before the gum has healed — but there is really no cause for concern. Done properly and according to principle, immediate placement is one of the techniques capable of producing the finest results.

The benefits of immediate placement are as follows.

1. It minimises the bone shrinkage that follows extraction (particularly valuable for front teeth, where appearance matters most). 2. It makes full use of the socket's high healing capacity during bone grafting. 3. In most cases no gum incision is needed (less pain and faster recovery). 4. It minimises the number of anaesthetics and procedures. 5. It shortens the time to the finished restoration.

Of these, the first two are the real advantages. As the site heals after extraction, the tissue inevitably shrinks — both the bone and the soft gum tissue. Placing the implant at the same time as the extraction, with the right measures, keeps that loss of tissue to a minimum.

The hole left in the bone after an extraction is called the socket, and its capacity to heal is at its greatest for about two weeks immediately afterwards. Taking advantage of that window, when the body offers extraordinary regenerative power, means grafted bone is far more likely to form well — and in my experience recovery after surgery is markedly faster too.

Dentists differ in the techniques they prefer. In my own practice, whenever a tooth must be removed and an implant placed, I work on the principle of immediate placement in every case — except the extreme ones where the bone is so badly destroyed that there is simply nothing to place into — and the results have been very good.

Patients are very pleased, because treatment time is dramatically shorter and there are fewer anaesthetics and procedures. Let us now look at a few cases of immediate placement in the molar region.