As more clinicians move to early implant placement, we are getting a lot of questions about whether the procedure should be guided or unguided. Of course, guided implant placement is great technology, but for a clinician with years of experience doing unguided implant placement it becomes a question of not which method is better, but when is guided placement indicated over unguided. The direct answer to this question is the state of mineralization of the tissue and the clinician’s experience with early implant placement.
One of the major advantages of early implant placement over immediate placement is that the implant is being placed completely into healthy, vital, mineralizing tissue filled with active osteoblasts as opposed to a significant portion of the implant being in non-living material. When you place an immediate implant, even when using our graft material (Immediate Graft), you hope you get full mineralization to the collar of the implant. However, with immediate implants, it is not uncommon to be left with some angular defects near the coronal portion of the implant or a failure to integrate. If you are using cadaver graft material, you never get integration to the grafted portion of the implant and the graft site breaks down over time.