Anterior Immediate Dental Implants with Temporization

When an anterior (front tooth)  is lost due to trauma, a cavity, or a fracture, an Immediate Anterior Dental Implant placement with Temporization (temporary crown is placed on top of the implant at the time of surgery) can be a valid treatment protocol. This is the first part of a 2 part series explaining the benefits of extracting a tooth and replacing it with an immediate dental implant using this treatment approach.

This treatment protocol can be used to manage the above sceanrio, however it is a very delicate procedure and is highly technique sensitive that requires experienced specialists, prosthodontists and periodontists to achieve optimum results to minimize the associated risks. If this procedure is mismanaged and or complications arise, the effects can be long lasting and devastating to both the patient and doctor.

PATIENT BENEFITS

The success rates of anterior immediate dental implants  are estimated at 97%1 and compare favorably to the traditional 2-staged treatment approach (tooth is extracted, after 4-6 months of healing, a dental implant is placed and restored with a permanent crown).

The main benefit to the extraction of an anterior tooth with an immediate implant placement and temporization is the preservation of both the bone and gum tissues. This protocol helps to minimize the amount of bone and soft tissue shrinkage that occurs after a tooth is removed and helps to maximize the esthetic appearance of the permanent implant crown. Additionally, from a patient’s point of view, placing a temporary crown on the same day of the implant placement, has an immediate psychological benefit of never being without a front tooth.

When a tooth is extracted, the tooth’s socket will biologically remodel and shrink in both a vertical and horizontal manner.2 As depicted in Figure 1, when a tooth is extracted, the periodontal ligament (shock absorber surrounding a tooth) is removed. This structure is a major source of the blood supply to a tooth and surrounding bone.

Figure 1: Remodeling & Healing of an Extracted Tooth

When an implant is immediately placed into the extraction socket of a tooth and a temporary crown is placed on top of the implant, this will minimize the amount of horizontal/vertical bone and gum  shrinkage after a tooth is extracted (Figure 2).

Figure 2: Remodeling & Healing of an Extracted Tooth with an Immediate Implant Placement

As a result, when a tooth is removed, the major blood supply to the tooth and bone is removed and a phenomenon of disuse atrophy will occur. Thus, when a tooth is removed and left to heal, the original anatomy will biologically remodel and it is very difficult if not impossible to recreate the original tooth’s dimensions.  

A second major advantage is the reduced treatment  time and decreased patient pain. In the past, the time for the completion of the traditional approach was 6-9 months. The total of treatment time for the extraction of an anterior tooth with an immediate implant placement with temporization treatment approach is 4 months. Thus, the treatment time is reduced by 50%.

This treatment protocol is minimally invasive and it is accomplished by autramatically removing the tooth, preserving the surrounding bone and gum tissues. This signficantly reduces the amount of pain and swelling after the procedure. Over the counter pain medications can be taken to manage the mild discomfort and patients can go to work the same or following day with minor alterations to their daily schedule.

The case below illustrates an an actual patient that was sucessfuly treated at our practice.

SUMMARY

If you are faced with a decision to replace your front tooth, refer to this article and ask questions about your treatment with your provider. We at PDG are specialists who routinely treat these types of cases and we welcome an opportunity to serve you. We encourage second opinions to ensure that you are well educated and informed, so that you can make an informed decision. 

Our practice is unique because we have the training and experience to manage both the placement and restoration of your dental implant. This provides us an opportunity to achieve a more predictable and esthetic result. Additionally, we have two full time experienced dental hygienists, whose main focus is preventative to promote the longevity of teeth and thier restorations.

Information about the Author: Dr. Tassos Sfondouris is a board certified periodontist and restorative dentist. He is a clinical research associate at NIH. He is passionate about periodontal and restorative therapies that promote the health, comfort, and function of teeth. He welcomes your comments, suggestions and encourages you to like him on Facebook or follow him on Twitter to get the latest unbiased information on pertinent dental health topics.

REFERANCES

  1. Kan JYK, Rungcharasseng K, Deflorian M, Weinstein T, Wang HL, TestoriT. Immediate Implant Placement and Provisionalization of maxillary anterior single implants. Periodontolo 2000. 2018 Jun: 77 (1): 197-212.
  2. Pagni G, Pellegrini G, Giannoble W, Rasperini G. Post Extration Alveolar Ridge Preservation: Biological Basis and Treatment; Int J Dent 2012; 2012

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