Early Implants: Pushing the Envelope onBone Regeneration
Tooth was extracted and grafted with Socket Graft Injectable on 10/28/2019. This low res CBCT slice is from the day of implant placement, 11/19/2019, just 3 weeks later. Cytoplast membrane was removed, and implant was placed fully guided. You can see calcification already starting in the socket.
Immediate implant placement is common but has been shown to have a higher rate of complications and a higher rate of failure to integrate. In addition, when immediate implants are grafted with cadaver bone grafts, studies have shown that progressive bone loss occurs indefinitely: Retrospective cohort study of 4,591 dental implants: Analysis of risk indicators for bone loss and prevalence of peri-implant mucositis and peri-implantitis. Also, unless the immediate implant is temporized, the gingiva collapses, producing an esthetic defect.
Delayed implant placement has been shown to be the most successful and predictable method of tooth replacement. However, delayed implant placement also comes with a lengthy time to restoration and collapse of the gingiva. In delayed implant placement, the bone that contacts the implant needs to be resorbed before integration occurs, delaying implant integration.
Early implant placement overcomes the negatives of immediate and delayed implant placement. A main advantage of early implant placement is the maintenance of the gingiva producing excellent esthetic results. In addition, early implant placement places the implant into the regenerating tissue as socket mineralization is occurring. At the early time frame of 2-6 weeks, the socket is filled with an abundance of mineralizing osteoblasts that are not present after bone has formed, resulting in rapid improved integration. However, the main advantages are what the patient experiences clinically with shorter times to restoration, but mainly the implant placement is quick, painless, and with rapid healing. A patient who experiences an early implant placement as presented in this case will no longer accept delayed implant placement.
Dr. Bickel is a long term customer of SteinerBio but is not associated with SteinerBio. He is very willing to share his knowledge and if you have any question about this methodology, he can be reached at:
Dr. Matt Bickel
428 Ganttown Rd.
Sewell, NJ 08080