Traditionally, when a tooth was lost or extracted, it was necessary to wait three months to insert the implant and another three months to place the crown.
Thus, the treatment had a total duration of approximately six months.
The reason for waiting three months to insert the implant was that this is the period it takes for the alveolus -the hollow in the bone where the tooth is housed- to heal.
However, about 20 years ago, some dentists and maxillofacial surgeons began to change the traditional protocol for implant placement.
Changes in implant technique
As we mentioned before, two decades ago implantologists modified the way to insert dental implants.
After performing the extraction, some of these professionals stopped waiting three months before placing the implant.
What they began to do, therefore, was to insert the titanium screw immediately after extracting the tooth.
In this way, the treatment lasted only three months.
And, in this time, the patient underwent a single surgery and the area underwent a single biological trauma.
At this point, it is important to clarify that the new protocol mentioned above can only be carried out on incisors and canines.
On the other hand, it cannot be performed on molars, since the roots are very wide and the space they leave is too large to be able to fix the implant as soon as it is extracted.
Therefore, in the case of implants in molars, it is necessary to wait three months for the bone to remodel and for the space to fill naturally.
After this time, the implant can be fixed.
Dental implant
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ADVANTAGES OF DENTAL IMPLANTS
What are the advantages of immediate implant placement?
Apparently, the procedure by which the implant is placed immediately after extraction has important advantages for the patient.
First of all, the person only undergoes one surgery.
In contrast, in the traditional protocol two surgeries are necessary: one when the tooth is extracted and another to place the implant.
Secondly, the treatment time is shortened.
That is to say, it has a total duration of approximately three months instead of six.
Even so, and leaving aside the obvious advantages for the person, the truth is that it was not until 2010 that studies appeared that corroborated this technique.
From that year onwards, relevant studies established whether this new protocol could imply any damage or anomaly in the healing process of the alveolus.
Placing the implant just after the tooth has been extracted has many advantages for the patient
Bone resorption following extraction
In addition, there was a belief among dentists and maxillofacial surgeons that with the immediate implantation procedure the bone remodeling process was slower.
This remodeling process occurs whenever a tooth is lost.
It is due to the fact that the bone surrounding the root of the tooth disappears and the alveolus adapts to its new edentulous situation.
This remodeling of the bone is very marked during the first four months after extraction.
After this period, bone loss proceeds more slowly.
Such was the belief that immediate implantation solved this problem that conical implants were designed -traditional implants are cylindrical-.
Conical implant
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CONICAL DENTAL IMPLANT
It was thought that bone loss would be less if the space was immediately replaced with an implant that imitated the natural root of the tooth.
Conclusions of the clinical study
In view of the above, it was necessary to carry out an exhaustive study to prove or disprove these theories.
This research was carried out jointly by the University of Gothenburg (Sweden), the University of Bern (Switzerland), a private clinic in Padova (Italy) and the Complutense University of Madrid.
Dr. Alberto Wintergerst, implantologist and periodontist at DrAW Dental Clinic, actively participated in the study.
To carry out the work, the researchers designed a multicenter randomized clinical study in which the two types of implants were studied: cylindrical and conical.
In this way, the aim was to demonstrate whether bone loss was less when conical implants were placed.
In order to carry out the study and find statistically significant results, a relatively homogeneous and large sample was chosen.
The sample consisted of adult men and women of different age groups.
Once the conclusions of the study were analyzed, it was shown that the cylindrical implant healed better.
However, there was no significant variation in the process of alveolar shrinkage or in the degree of bone loss.
In other words, in terms of bone loss, placing an implant immediately does not have a benefit in the final result of the treatment.
This means that, even if the implant is inserted immediately, it is always necessary to regenerate to prevent the future resorption that will occur.
Do not let time pass
Since bone loss is caused by missing teeth, it is advisable to have implants placed before a lot of bone mass has been lost.
So how does the socket respond?
At this point, it is essential to explain in detail the disadvantages of the alveolus contracting.
Just as we have previously explained that excessive compression of the bone is detrimental to the resolution of the treatment, the same does not occur with the alveolus.
During the three months following extraction – whether or not an implant is placed during this time – the gingiva and bone remodel themselves.
Thus, there will be a horizontal loss of 40% of the gum volume and a vertical loss of between 1 and 2 millimeters.
Thus, there will be a concavity in the gum that will be a disadvantage for the esthetics of the treatment.
In other words, if the thickness decreases considerably, the metal of the implant will become transparent.
The tooth is divided into several parts
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PARTS OF A TOOTH
In addition to the esthetic effects, the concave shape acquired will also cause hygienic disadvantages, as food will tend to be stored in the area.
Given the inevitable loss of gum volume, when a tooth is extracted or lost in the anterosuperior sector -the most visible area- periodontal plastic surgery techniques will have to be performed.
In this way, not only will the lost tooth be replaced, but also the gum volume previously present will be restored.
These periodontal plastic surgery techniques can be:
The grafting of connective tissue from the palate to restore the gum volume.
Bone substitute biomaterial to compensate for bone loss.
That is, depending on the loss that has occurred, it must be determined if the solution is simply a gum graft or if bone must also be added.
MAKE AN APPOINTMENT TO HAVE AN IMPLANT PLACED
How do we perform this process at DrAW Dental Clinic?
After the conclusions derived from the study, we are going to explain how our Implantology team proceeds.
Dr. Alberto Wintergerst performs periodontal plastic surgery at the same time as tooth extraction and implant placement.
Therefore, in view of the conclusions obtained in the clinical study, we can affirm that immediate implantation is a safe procedure.
Thus, it can be carried out in a predictable manner as long as we compensate for future bone loss with a graft.
In addition, this protocol shortens the traditional procedure -which lasts 6 months- and carries out the treatment in only three months.
In this way, the new protocol has important advantages for the patient:
Discomfort, the number of surgeries and the time to rehabilitate the lost tooth are reduced.
Predictable esthetic and functional results are achieved.
Therefore, we will apply it whenever possible.
However, the best way to know if you can undergo this surgery to recover the functionality of your teeth and mouth is through an evaluation.
Therefore, if you are interested in using this method to place your implants, we encourage you to ask for a free first appointment with our dentists.
You can do so by calling +52 664 590 8321 or filling out our web form.
