The 5-Minute Implant

As bone graft technology improves, clinical therapy improves.
Quicker completion of treatment, both from a perspective of length of time to complete therapy and length of chair time, benefit both dentist and patient. Elimination of invasive surgical therapy again benefits both dentist and patient. Less postoperative pain for the patient and less postoperative care for the dentist are additional goals for improving clinical care. The following cases encompass all of the above and represent a new paradigm for replacing molar teeth with implants.
Failing #19

All walls are intact so implant placement is planned for 6 weeks.

Socket Graft™ is used for the graft material, covered by a d-PTFE membrane according to the protocol previously outlined in a previous post on the suture less membrane technique. When a molar site is planned for early placement, the interradicular septum is removed in order to facilitate implant placement and avoid implant displacement. This photograph shows the removal of the interradicular septum at the time of extraction.

2 Weeks
The patient is seen two weeks after extraction and grafting to access the pace of bone regeneration. Bone regeneration in the socket is proceeding normally showing approximately 75% mineralization of the socket. The patient is scheduled at four weeks post extraction for membrane removal and 6 weeks post extraction for implant placement.
4 Weeks
The membrane is removed at 4 weeks to allow for the crest to cover with a thin layer of epithelium.
6 Weeks
At six weeks, the socket is nearly filled with mineralized tissue and ready for implant placement.
6 Weeks
At six weeks, the crest is covered with a thin layer of epithelium. When the osteotomy is prepared without flaps, the mineralized tissue can be probed just under the surface epithelium.
Implant placement 6 weeks after extraction.
With removal of the interradicular, septum the implant is easily placed in the ideal position. The use of a d-PTFE membrane with the suture less technique maintains the original gingival thickness and the protocol is to place the healing abutment so it is flush with the gingival crest.
Implant in place 6 weeks after extraction.
If done freehand the majority of time is used taking radiographs. If this procedure is done guided implant placement is a 5-minute procedure.
The 5-Minute-6-Week Implant
The following case will demonstrate the the 5-Minute-6-Week implant protocol through to restoration.
Tooth #19 presents with caries and periodontal bone loss and is scheduled for extraction. #18 was extracted and grafted with Socket Graft™ followed with implant placement in 2014. #19 was extracted, grafted with Socket Graft™ and covered with a d-PTFE membrane according to protocol for using the sutureless membrane technique.
At two weeks, the membrane has become dislodged and is removed.
2 Weeks Post Extraction
While the membrane was dislodged good bone regeneration is occurring in the extraction socket. The normal sequence for early implant placement for molars is for membrane removal at 4 weeks and implant placement at 6 weeks. However, patient schedules often require modification.
7 Weeks Post Op
At seven weeks, the gingival is still hypertrophied from the sutureless membrane technique. The surgical site has epithelialized.
7 Weeks Post Extraction
Good bone fill is noted at the 7-week implant placement appointment.
Implant placement at 7 weeks.
Early implant placement does not require flaps. The healing abutment is placed flush with the gingiva.
7 Weeks Post Implant Placement
Note the gradual reorganization of the gingival architecture. In early implant placement, the socket bone and the gingiva heal in unison as the implant integrates.
8 Months Post Implant Placement
Excellent bone is maintained to the collar of each implant.
8 Months Post Implant Placement
With the protocol used for extraction and grafting in combination with early implant placement, normal gingival architecture is maintained producing a healthy, cleansable, esthetic restoration.
The 5-Minute-6-Week molar replacement protocol significantly reduces the length of time required for treatment, chair time, and surgical trauma to the patient. Because delayed implant placement results in collapse of the gingival architecture, the 5-Minute-6-Week molar implant protocol produces superior clinical outcomes.

The SteinerBio tooth replacement protocol for all the dentition is as follows:
  • Maxillary incisors: Immediate implant placement, grafting with Immediate Graft™, healing abutment placed flush with the gingival crest, bonded with Oral Bond™. No membrane.
  • Bicuspids: Grafted with Socket Graft™, covered with d-PTFE sutureless membrane, removed at 4 weeks with implant placed at the 4 week membrane removal appointment.
  • Molars: Grafted with Socket Graft™ and covered with a d-PTFE sutureless membrane. Membrane removed at 4 weeks and implant placed at 6 weeks.
  • Sockets with missing walls are grafted with Socket Graft Plus™, covered with a sutured d-PTFE membrane with implant placed in 3 months.
  • All implants are refereed for restoration 2 months after implant placement.
We will be following up with cases outlining each tooth replacement method. Please be advised the properties of SteinerBio graft materials allow for the described protocols and any other graft material will fail to provide acceptable results when using the 5-minute implant protocols.

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American Society for Bone and Mineral Research (ASBMR)

Tissue Engineering and Regenerative Medicine International Society (TERMIS)