This protocol is typically used for implants at single rooted teeth (bicuspids and front teeth) and can also be used in full arch cases but it is not usually used for molars (back teeth). For immediate placement there should be no infection present and good quality bone around the extraction socket. The advantage is the time to completion is reduced but it does have potential to increase complication rates.
Stage 1 surgery – the tooth is extracted and the implant is placed in the socket and beyond to engage solid bone. The gum is then placed just adjacent the implant. The bone then is allowed to heal for 3months (osseointegration). In some cases if the implant is very stable then an immediate crown can be provisionally placed.
Restorative visit – at your dentist who places the abutment and the final crown.
When bone grafting is required
Bone atrophy (resorption) basically describes the process of wasting away of body tissue (bone in this case) as a result of cell degeneration. It is a natural phenomenon that occurs after the extraction of teeth, which can be exacerbated over time due to dentures. Patients who have worn dentures for many years and have advanced atrophy of the jaw sometimes don’t have the necessary quality or volume of bone that’s required for dental implants.
If your jawbone isn’t thick enough or is too soft, you may need bone grafting before you can have dental implant surgery. That’s because the powerful chewing action of your mouth exerts great pressure on your bone, and if it can’t support the implant, the surgery likely would fail. A bone graft can create a more solid base for the implant.
There are several bone graft materials that can be used to rebuild a jawbone. Options may include a natural bone graft, such as from another location in your body, or a synthetic bone graft, such as bone-substitute material that can provide support structures for new bone growth. Talk to your doctor about options that will work best for you. It may take several months for the transplanted bone to grow enough new bone to support a dental implant. In some cases, you may need only minor bone grafting, which can be done at the same time as the implant surgery. The condition of your jawbone determines how you proceed.
Bone grafting procedures in the jaws are successful but the disadvantage is prolonged treatment time (extra stages needed for bone graft placement, healing and maturation and then implant placement). Additionally, a denture will be needed while the bone grafts heal (for 3-4 months). Sometimes the bone graft is rejected (if it doesn’t heal properly) and you often experience more pain and swelling when certain types of bone graft (block) are used.