Immediate implant, a new tooth immediately after tooth extraction

What does immediate implant mean?

An immediate implant refers to a dental implant that is placed immediately after tooth extraction in the same location in the jawbone.

When a tooth is removed, a hole remains in the jawbone, known as an extraction socket. In traditional implant treatment, this socket is allowed to heal for several months before the implant is inserted.

With immediate implants, the implant is placed directly into this extraction socket during the same procedure.

In international literature , this method is referred to as immediate implant placement.

What is a dental implant?

A dental implant is an artificial tooth root that is placed in the jawbone to replace a missing tooth. The different stages, benefits, and options of implant treatment are described in more detail on the dental implant page.

Implants are usually made of titanium or a titanium alloy. Titanium is a material that is well suited to human tissue and is able to form a permanent bond with bone tissue.

Once the implant has been placed in the jawbone, bone tissue begins to grow against the surface of the implant. This biological process is called osseointegration.

Once osseointegration has been successfully achieved, the implant functions in much the same way as a natural tooth root. A crown, bridge, or denture can be attached to it.

The goal of implant treatment is to restore:

• bite force
• clarity of speech
• natural appearance of a smile

Unlike dental bridges, implants do not require the grinding down of adjacent teeth.

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What happens in the jawbone after a tooth extraction?

When a tooth is removed, several biological changes occur in the jawbone.

The root of a tooth is normally attached to the jawbone via the periodontal ligament. This connective tissue structure transmits chewing forces to the bone and maintains bone metabolism.

When a tooth is removed

• periodontal ligament disappears
• bone load changes
• bone tissue gradually begins to resorb, i.e., atrophy

Studies show that the width and height of the jawbone can decrease significantly during the first few months after tooth extraction.

This is one reason why implant treatment is often planned as early as possible.

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Why can an implant sometimes be placed immediately?

An immediate implant is possible when the bone surrounding the extraction site is sufficiently strong and healthy.

Implant placement requires that the implant be immediately mechanically stable in the jawbone. This is called primary stability.

Primary stability is usually achieved by anchoring the implant to the denser bone outside the bottom or walls of the extraction socket.

If this is successful, the implant can begin to ossify in place in the same way as in delayed implant treatment.

What happens to the tissue during immediate implant treatment?

The success of implant treatment is based on a complex biological healing process. You can read more about implant treatment on the dental implant page.

Bone healing

When an implant is placed in the jawbone, minor surgical trauma occurs in the bone tissue. During the healing process, bone cells begin to form new bone against the surface of the implant.

The surface of the implant is microscopically rough, which facilitates bone attachment to it.

Osseointegration

Osseointegration refers to a direct structural connection between the implant surface and living bone tissue.

Once osseointegration is complete, the implant is effectively part of the jawbone. The implant can then withstand chewing forces in the same way as the root of a natural tooth.

Osseointegration usually takes a few months.

Healing of soft tissues

In implant treatment, the gums, or soft tissues, are also important.

Well-healed gum tissue protects the implant from bacteria and helps create a natural-looking gum contour around the crown.

This is particularly important for front teeth, where the aesthetic result is crucial.

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Immediate implant vs. traditional implant treatment

In traditional implant treatment, the treatment pathway usually proceeds as follows:

1. The tooth is removed.
2. The jawbone is allowed to heal for several months.
3. The implant will be placed later.
4. The implant will take a few more months to fuse with the bone.
5. The final crown is manufactured

With immediate implants, some of these steps are combined.

The tooth is removed and the implant is placed during the same procedure. This can significantly shorten the treatment time.

However, it is important to understand that the final crown is often only made once the implant has properly healed.

Who is an immediate implant suitable for?

Immediate implants are not suitable for all situations.

A good candidate for treatment is usually someone who

• there is sufficient jawbone around the implant
• the walls of the removal pit are intact
• there is no widespread infection in the area
• general health is good
• oral hygiene is good

In addition, bite forces and implant location influence the treatment decision.

When can an immediate implant not be performed?

In some situations, it is not advisable to insert an implant immediately after tooth extraction.

Such situations may include, for example

• extensive inflammation around the tooth
• significant bone loss
• damage to the walls of the removal pit
• insufficient primary stability
• general illnesses that slow down healing

In such cases, traditional implant treatment may be a safer option than immediate implantation.

How is the treatment carried out in practice?

Research and treatment planning

A thorough clinical examination is performed prior to implant treatment. X-rays or cone beam computed tomography (CBCT) are also often used to assess bone quantity and anatomy.

Tooth extraction

The tooth to be extracted is removed as gently as possible. The aim is to preserve the bone structure of the extraction site as intact as possible.

Implant placement

The implant is placed in a precisely planned location in the jawbone. The stability of the implant is ensured surgically.

Temporary crown

In some cases, a temporary crown can be attached to the implant immediately. In this case, the bite is adjusted so that the implant is not subjected to excessive stress during healing.

The final crown

Once the implant has properly fused with the bone, the final ceramic crown is fabricated.

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What does research say about immediate implants?

Several clinical studies have shown that immediate implants can be predictable in correctly selected situations.

Based on current research data, the success rates of immediate implantation are in many cases close to those of traditional implant treatment.

However, it is important that patients are carefully selected and treatment is planned meticulously.

What will the patient notice after treatment?

After implant treatment, the following may occur in the area

• mild swelling
• shyness
• minor bleeding

These symptoms are usually temporary.

During healing, the implant is protected from excessive chewing pressure. Oral hygiene is important for normal healing.

Summary

• An immediate implant is a treatment method in which a dental implant is placed immediately after tooth extraction.
• This method can shorten the overall duration of implant treatment and, in some cases, enable the immediate placement of a temporary crown.
• However, immediate implants are not suitable for all situations. The treatment decision is always based on an individual assessment that takes into account the amount of jawbone, the condition of the tissues, and the patient's overall health.

Further information on dental implant treatment 

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Frequently asked questions about immediate implants

Can an implant be placed immediately after tooth extraction?

In some cases, yes. If there is sufficient jawbone and the extraction site is healthy, the implant can sometimes be placed immediately after tooth extraction.

Is an immediate implant safe?

Based on current research, immediate implants can be predictable in correctly selected situations. However, treatment is always planned on an individual basis.

Does implant placement hurt?

The procedure is performed under local anesthesia, so you will not usually feel any pain during the actual treatment.

How long does it take for an implant to fuse with the bone?

The implant usually takes a few months to fuse with the bone. The final crown is often made after this healing phase.

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