Implant and tooth on the day of extraction: when is it possible?
"Can the tooth be taken out and the implant placed straight away?" Patients ask this very often, especially for a front tooth. The answer is: sometimes, under clear conditions. Two separate decisions are involved, and they are often confused.
Two separate decisions
- Immediate placement: the implant is placed in the socket on the day of the extraction.
- Immediate loading: a temporary tooth is fixed onto the implant the same day or in the following days.
An implant can be placed immediately without a tooth on it, and conversely a temporary tooth can be fixed on an implant placed in healed bone.
The four possible times to place the implant
| Timing | When | For which situation |
|---|---|---|
| Immediate | On the day of extraction | Intact socket, no acute infection, good gum |
| Early, after gum healing | 4 to 8 weeks later | Most common situation for a front tooth |
| Early, after initial bone healing | 12 to 16 weeks later | Damaged bone wall, infection |
| Delayed | After several months | Major bone loss, often after socket preservation or a graft |
The conditions for an immediate implant
Immediate placement can be considered when:
- the bone wall on the lip or cheek side is intact and thick enough;
- there is no acute infection around the tooth: with an active abscess, waiting is usually preferred;
- the gum is of good quality, especially in the smile zone;
- the bone beyond the root can anchor the implant firmly: stability at placement is essential;
- the patient does not smoke, or smokes little, and general health allows it.
The 3D scan at the practice makes it possible to check the thickness of the bone wall and the bone available before surgery. The final decision is made during surgery, after the extraction, based on what is seen.
The benefits
- One less procedure and a shorter treatment.
- No period without a tooth when the temporary tooth can be fixed onto the implant.
- Good preservation of the gum around the future tooth when the conditions are met.
The risks and limits
- Gum recession: in the aesthetic zone, this is the main risk of a poorly indicated immediate placement. Literature reviews show it is more frequent when the outer bone wall is thin or damaged.
- Insufficient stability: if the implant is not firm enough at placement, it cannot carry a temporary tooth and conventional healing follows.
- Infection: this is why delayed placement is often chosen with an active abscess.
When these conditions are not met, waiting a few weeks is not a failure: it is often the way to a safer, longer-lasting result.
The same-day temporary tooth
When the implant is stable, a temporary tooth is fixed that does not touch the teeth of the opposite jaw. It is there for appearance and to shape the gum. During healing you must not bite on this tooth. The final crown is made once the implant has fused with the bone, usually after a few months. The other temporary options are described in Will I be left without a tooth?.
Frequently asked questions
Is it more painful than an implant placed later?
Usually not. The extraction and placement are done under local anaesthesia, in a single procedure.
Does an immediate implant last as long?
When it is well indicated, survival rates are comparable to those of an implant placed later. The aesthetic risk to the gum is the main difference.
Is it possible for a molar?
Sometimes, depending on the bone between the roots. For molars, placement a few weeks after the extraction is often simpler.
Is it possible for a full jaw?
Yes, in some situations: extractions, placement of four to six implants and a temporary bridge fixed quickly. See Implant denture or fixed bridge?.
In short
- Placing the implant on the day of extraction is possible when the bone, the gum and the absence of infection allow it.
- A fixed temporary tooth on the same day depends on the stability of the implant.
- For a front tooth, waiting four to eight weeks is often the safest choice.
- The 3D scan and the examination of the socket guide the decision.
Sources
- Hämmerle CHF, Chen ST, Wilson TG. Consensus statements and recommended clinical procedures regarding the placement of implants in extraction sockets. Int J Oral Maxillofac Implants, 2004.
- Chen ST, Buser D. Esthetic outcomes following immediate and early implant placement in the anterior maxilla — a systematic review. Int J Oral Maxillofac Implants, 2014.
- Gallucci GO et al. Implant placement and loading protocols in partially edentulous patients: a systematic review. Clin Oral Implants Res, 2018.
This article is general information. Only a consultation can determine which solution suits your situation.
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