Over the past decade there has been a lot of buzz in the media about same day implants and teeth. In some cases, a smile can be restored with a single implant and crown or with multiple implants and a set of teeth in just one day. Dentists must use good judgement when assessing a patient to determine whether same day implant restoration is a good option for that patient. In many cases it is much more difficult to place a single implant and restore it with a crown the same day than it is to place multiple implants and a full set of teeth in one appointment.
Whenever possible, placement of an implant the day a tooth is removed is a dentist’s first choice. Same day placement shortens the overall treatment time and allows for only one period of healing. However, much of the time, it is NOT advised to place a tooth on a single implant the same day. Just as concrete needs to set around a pole in order for the pole to be stable, bone needs to fuse to the implant in order for the implant to take hold. Immediate placement of a tooth requires extreme caution by the patient not to use the tooth for a few months. Many patients and dentists do not want to take the risk of having an implant fail from pressure being placed on the implant too soon during the healing phase. Patients who are concerned about the way their smile looks can have a retainer with a temporary tooth made to replace the missing tooth in the meantime.
If a tooth is to be removed and there is active periodontal disease or an abscess in the area, an immediate implant may not be possible as bone grafting and time for healing may be needed before an implant can be placed. Also, if the gums in the area are thin and in poor condition, an immediate implant may not be possible because grafting of the gum tissue may be required first. In some cases of implant replacement of an upper back tooth, especially if the tooth has been missing for a period of time, the sinus spaces may have dropped down into that area which means there is little bone above the missing tooth space. In this case, a surgical procedure called a sinus lift may be necessary before an implant can be inserted.
If someone has no teeth or only a few teeth, often there are areas of the arch where there is still sufficient bone so that removal of the remaining teeth does not interfere with placement of 4 to 6 implants at the same appointment. Then a complete set of teeth that have been made in advance can be attached immediately to those implants. However, in some cases the bone is too weak or thin or the gums are too fragile, so bone and/or gum grafting the area and allowing for healing first is necessary.
Implants are a wonderful way to replace missing teeth. They feel much more like natural teeth than any other prosthesis we have at our disposal in dentistry, and they can last a lifetime, but don’t rush them! Allow your dentist and surgeon to devise a treatment plan that will give you the best long-term results so that your new smile functions and looks great for many years to come!