Immediate Dental Implants…Things To Consider

Immediate Dental Implants…Things To Consider

Immediate Dental Implants…Things To Consider

“Immediate loading” is a hot topic in implant dentistry.

In its most basic definition, it means you will have a tooth on your dental implant within 24 -48 hours of surgery.

Here is an example of the entire lower jaw replaced with nine implants and an immediate bridge:

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Every patient that I have treated has always wanted his or her teeth right away. You really should weigh the risks versus benefits of this procedure.

Immediate teeth work best for teeth in the front of the mouth.  It also works very well if you are missing all your teeth and is most successful if you are having implants for your whole lower or upper jaw.  The use of zygomatic implants also allows for same-day teeth in people that are missing all upper teeth even when they have soft bone.  When the dental implants are put in, I would make a temporary tooth or whole set of teeth right on the spot.  You would walk out of my office with teeth not gaps. The temporary teeth will look, feel and work like your regular teeth.

You have a big role in the success of this awesome procedure.  I will tell you, that you have to be committed to a soft diet for about 3 -6 months. Even though a tooth is made on the immediate, same day implant, it still has to fuse to your bone. This is called “osseointegration.”  If you can’t commit yourself to this, immediate loading or immediate temporaries are not for you. It has a high risk of failure if you chew harder foods too early. All of the implants can fail.

If it were just one tooth, like your front and center upper tooth, I would make the immediate temporary so it doesn’t touch the bottom teeth. This further prevents the chance of using the tooth too early.

Some of the important factors in determining if immediate loading can be done are:

  • Bone density
  • Amount of bone
  • Initial stability of the implants
  • Shape and type of gum
  • Implant design and type
  • Your bite

What’s the race to get a tooth today? I am all for immediate dental implants when it does not pose a significant risk of failure to you.  Meaning if it is just as successful to have the immediate implant, as it is the traditional “delayed” approach, then you should strongly consider it. It may even reduce the total cost, too and saves time.

I have a lot of experience in this and let me tell you this is not for the novice implant dentist. One tiny error can yield disastrous results.

The next level up is an immediate implant with a temporary on the same day the tooth is extracted! This is a very common procedure I perform in my office in Burbank, California for the last 18 years.  I most commonly do this for front or side teeth.  If there is infection, it may not be an option for you.  Sometimes the infection dissolves the really thin bone on the outside surface. If this is the case, an immediate dental implant is not recommended.

Here is an example case of a front tooth immediate dental implant. 

A bone graft is sometimes necessary with immediate load dental implants and can be done at the same appointment. Every situation is so different.

With any situation you should have a back up plan.  In my opinion, this procedure is a bit “over-marketed” as a solution for everyone, but it really only accounts for about 5-15% of situations.  There are times that immediate implants are planned, but during the surgery I find that the bone or implant is not strong enough and I have to abort and not put the implants in that day.

I always have a back up temporary tooth ready just in case!

Bottom line…. immediate dental implants are great in the perfect situation. Pre-surgical planning and expert execution of the procedure makes all the difference.

Please feel free to ask questions and comment below!

18 Comments

  1. I just got back from the dentist and was recommended by the Dr and and some others.Has anyone had a full retraction or full extraction to heal and go without 8 weeks. I’m very vain and entertain lip syncing as a performer. Can I get the immediate then have them do the custom ones in a few months. Any issues?

    September 5, 2019 at 12:09 am Reply
    1. Ramsey Amin

      That type of pre-procedural waiting has some merit but in most cases is not needed and can actually cause a complication with a poor cosmetic outcome.

      September 14, 2019 at 10:51 pm Reply
  2. Mercedes Acosta

    At the age of 80, can I change my protesis (both) for an implant? thanks.

    March 24, 2019 at 5:30 am Reply
    1. RamseyAminDDS

      I don’t understand your question. I can tell you that that you are not too old!! I have done this on patients up to 93 years old!

      March 25, 2019 at 4:33 am Reply
  3. Courtney Adrian

    Hello, my son’s head collided with my front tooth about a week and a half ago and it’s starting to die by the way it’s changing color. I went for impressions today, and I’m going to get it pulled tomorrow with a temporary flipper. I’m only 28 years old and the last thing I want is invisible fake front tooth. I am wondering if it’s possible to get an implant same day, if the tooth has been pulled and healed for however how many months before I could afford an implant. I’m in Canada, and have been looking in the South for Implant options, as it is more affordable. I also do have bone loss, so I don’t know what my options are but I do want something that is more permanent and most natural-looking, do you know what options I have? Thank you in advance

    January 9, 2017 at 5:20 pm Reply
    1. RamseyAminDDS

      I hope you had a really good socket preservation bone graft. At age 28, I try to do everything possible to put the implant at the same time the tooth is removed. This can become very costly if you have to rebuild the bone rather than preserve what you have already. I’m hoping and praying that you had the implant put in to avoid costly bone grafting such as a bone block graft.

      May 30, 2017 at 4:57 am Reply
  4. M. Z.A

    I want to know lateral stability of screw inserted inside bone. What is the diameter of screw as a minimum to be used for single implant. How much length of screw will be be inseted inside bone.

    December 5, 2016 at 8:33 am Reply
    1. RamseyAminDDS

      Usually 3-4mm diameter and minimum of 8-10mm

      December 13, 2016 at 2:36 am Reply
  5. Dave Hill

    ? I plan on having 6 implants in my upper law. I am a new denture wearer (2 months now) and am waiting for the end of the 2 mon. to start the implant pro. Can I use 2 immediate load implants and mod. the full upper to hold without the glue while the other 4 are healing? Then once the other 4 have secured themselves I can add the 4 add. posts and have a new upper made holding on with the 6 studs. I am thinking about the ZEST large stud sys. (can’t remember the name of the new coated ones right now but those are what I am considering. ) This will be a removable over-denture.

    April 18, 2016 at 6:25 pm Reply
    1. RamseyAminDDS

      You would be happier with something that stays in your mouth like a Prettau dental implant bridge rather than a removable overdenture. The type of attachments your discussing are called locators. I like them for the lower jaw but not for the upper except in rare situations.

      April 20, 2016 at 11:55 pm Reply
  6. Gary Tikriti

    Hi Dr. Amin,
    I really like your article and I would like you to clear something.

    I broke my tooth (#8) in the front upper jaw and had it bone grafted last
    November 5th. My dentist told me that I have to wait 3 to 6 months before he can
    place the implant and abutment installed and about 4 months to place the crown,
    I’m currently in the first waiting period. Do I understand it right that the
    second waiting period (4 months) can be avoided i.e. the implant, abutment and
    crown can be done at the same time? or at least shorter time period! If not,
    what is the shortest time needed between the implant and the crown? I would
    appreciate some more information regarding this with an approximate cost
    involved.
    In addition, which system is used in “Immediate Loading” (a titanium dental implant with titanium abutment, a titanium dental implant with a zirconia abutment or all white zirconia implant one-piece), and what ‘s the cost involved? I shall be looking forward to hear from you. Thank you,

    – See more at: https://www.burbankdentalimplants.com/zirconia-dental-implants-pros-and-cons-video/#sthash.O7efvUUJ.dpuf the Immediate Loading?

    January 25, 2016 at 4:24 pm Reply
    1. RamseyAminDDS

      unfortunately I cannot answer your questions with regards cost. The upper front teeth are very complicated. Going slow is almost always better than going fast. Although immediate dental implant preserve the existing gum shape and bone, there can be disastrous results if things are moved to quickly. Is to qualify for any immediate implant, the implant itself must engage the bone about 30-40% longer than your existing root. Just because you have any immediate implants put in the same day it is extracted that does not mean that you can have an immediate temporary or an immediate tooth on top of it. I know this sounds complicated but a lot of this is determined by bone density and surgical experience. Shortening the waiting period, must be carefully chosen. I would not do an all zirconia abutment but and abutment that had a metal hex interfaced would be just fine. I do not suggest that the implant screw itself be made of zirconia as this is usually one piece and does not do well when the bone trajectory is angulated which often occurs in the upper front teeth.

      February 1, 2016 at 2:29 am Reply
  7. I actually wrote an article about this here:
    http://www.dentalimplantdentistryblog.com/2009/04/blood-thinners-and-dental-implants.html
    Does this help?

    January 5, 2010 at 6:32 pm Reply
  8. ADAM JELONEK

    Is therapy with PLAVIX contraindication to titanium implants?

    January 3, 2010 at 1:18 pm Reply
  9. Hi June,
    Sorry for the delayed reply. My computer hard drive crashed!
    Unfortunately, each situation is VERY unique. I suggest you get in touch with an expert implant dentist. Use the link in the upper right to find someone who is certified by the American Board of Oral Implantology.
    Do you have any x-rays you can post?

    October 20, 2009 at 10:19 pm Reply
  10. June Swinerton

    my endodontist almost refused to tell me what risk were involved in implants. I had front tooth root canal failure (was also crowned) and he immediately suggested implants- i mentioned retreatment- he claimed he had a 80 percent success rate. During the procedure I felt all was good, as soon as he was done he said the tooth was cracked. I heard it crack during the proceedure and it wasn’t on the first x-ray, now I am forced to do an implant and wasted 400 dollars for the attempted retreatment. I am not rich. I did have some bone loss- tooth number 8. I am apprehensive about an implant and got no information of the risk. What options do i have and what is a mini implant. the other front tooth was also crowned so I was wonderting about the bridge option too. I was told to go one type of specialist for the one solution, and another for a bridge- but I cant keep running around spending money (120) each just to talk about information. I found much on the internet and the dentist I have talked to have not supplied me with. I need to make a fully informed decision. Any help (even websites explaining risk) would help. June

    October 8, 2009 at 8:43 am Reply
    1. brett

      hi
      I am considering getting a number 31 tooth extracted and implanted on the same day with pre- loading. is this becoming more of common practice?

      thanks

      November 16, 2016 at 6:35 am Reply
      1. RamseyAminDDS

        please reference the area where your tooth is being removed. Tooth #31 in the American system is very different than tooth #31 in the international dental numbering system. One is a front tooth and one is a back tooth. The answers are completely different depending on the area.

        Immediate molar implants for American tooth #31 are possible using wide body dental implants.

        November 24, 2016 at 4:26 am Reply

Write a Comment

Monica D.
Monica D.
December 29, 2020.
There aren't enough words (and I have a lot of words) to tell you how grateful I am to have found Dr. Ramsey Amin and his wonderful staff. I had an enormous amount of bone loss and I was hopeless after being treated by a different doctor for two years. I had multiple procedures such as gum graft, extractions, and a sinus lift. After all of that, the doctor released me and told me he could not help me any longer. He sent me to a large teaching hospital - who also had no idea how to help me. I was terrified and embarrassed. I had been missing teeth due to those procedures since 2017. That sent me out on a journey of meeting with no less than five different dentist/oral surgeons. Most of them shamed me for the bone loss and wondered what I had done to cause this. In reality, I had done nothing. The bone loss is my body's immune system fighting me, as well as hereditary traits. In fact not only was I having difficulty being able to have implants, I also had so much bone loss that I was also not a candidate for dentures. I researched "what to do when you have bone loss and can't get implants" and I found Dr. Amin's website. Then I researched him, read his reviews, watched every one of his You Tube videos. I called and got an appointment, and kept going to consultations with other providers. I had long since stopped smiling and being social. Missing teeth and the shaming was affecting my life so adversely. When I met with Dr. Amin for my consultation he was ready. He had all of my records and had already reviewed my scans. But more than that, he genuinely wanted to get to know about my life. He was/is authentic, kind and extremely professional with so much success and experience in difficult cases like mine. He worked up a treatment plan & I came back two weeks later to discuss my options...and the journey began. I have had three procedures under IV sedation, no pain, no narcotics needed for aftercare. Dr. Amin is a consumate, experienced oral surgeon who cares about your health & understands your fears. He communicates every step of the way and will provide you with all the information you need to make a decision to improve your health. I am still working toward my end goal, and we had to zig from traditional implants and zag to zygomatic implants instead...which is the reason I chose him in the first place. If there was nothing else that could be done to get me healthy & smiling again, I knew he would have that option to help me. And of course 2020, the year of CV-19. Don't worry, Dr. Amin & his staff follow all health & safety protocols. This review is long, because it is important you know my journey, so you might understand how fortunate I feel to be healing. I'm torn, because this place is like a great restaurant, I want to shout from the rooftops how great it is, how great he is. And at the same time, I want to keep this all to myself. I come 75 miles each way to see him. I know people travel from all over the world for his expertise. Do yourself a favor, have a consultation. You won't regret it. Dr. Amin is amazing and so is his staff.
Jennifer B.
Jennifer B.
December 18, 2020.
I cannot speak highly enough of Dr. Amin and his professional staff. I have to start off and say that I am absolutely TERRIFIED of the dentist due to several past experiences. I found myself putting this off for YEARS until I was referred over to Dr. Amin. I was petrified on my first visit... but he along with his WONDERFUL staff made me feel so calm and at ease. I had quite a bit of work that needed to be done, but we found the perfect plan that worked out for me, and I couldn't be happier. Words cannot express my gratitude to each and every staff member that made me feel safe and comfortable. Dr. Amin was always so attentive in asking if I was ever in pain... and I never was. These are truly remarkable individuals, and I'm so lucky to have a dentist that I can trust. I ABSOLUTELY LOVE each and every one of you! Thank you,
D M.
D M.
December 17, 2020.
I cannot say enough positive things about Dr. Amin and his staff. I originally found them on Yelp about two years ago. I needed an implant, front tooth of all places, and was extremely nervous not only about surgery but about how it would turn out. Let me just say I just adore the staff. Everyone is crazy friendly and the whole office has a very positive vibe. The staff is adorable and always has me smiling by the time I leave. They are all thorough and on-point about what they do, and I truly appreciate it. They are quick to respond to my emails no matter the question, and their appointment reminders are great too. Dr. Amin is very thorough and reassuring, and answered any questions my husband or I had. My regular dentist had questions about the procedure and Dr. Amin's office even reached out to them at my request (my dentist said they never received a call, but Dr. Amin's staff had date, time and notes - love the thoroughness!). After surgery the Dr. called to leave me a message about how it went. Very minimal pain during healing, never any pain during any visits. It took a few tries to get everything just right for the permanent crown (color, etc), but the end result is beyond fantastic! At one point during healing I thought I was experiencing some looseness or wiggling but unfortunately couldn't make it to the office. When I was finally able to make it in the Dr. was so relieved, bless his heart. Luckily it was just a false alarm and everything checked out ok. They're a bit further out from me, but I wanted the best. I sure found it! I wish they were my regular dentist, and I'm looking forward to seeing them again for my check-up which was delayed due to COVID.
Melissa E.
Melissa E.
December 9, 2020.
I found Dr. Amin a few years back after I hadn't been to a dentist in a decade. Many traumatic dental experiences in childhood have made me so phobic that even getting a cleaning was a knee-knocking, heart-pounding trial. But finally I couldn't put off some things any longer. During my first anesthesia session, Dr. Amin replaced five old metal fillings, and during the second he did three more plus a crown. I was completely comfortable, and never felt a thing. Because they were extra-long sessions, I did sleep for about 12 hours after, but the next day I felt just fine. This past week, my back top tooth cracked in half and fell out of my mouth, and a couple days later the crown on the remainder of the tooth fell out too! Despite being nervous about Covid 19, I had to get it taken care of, so I called and quizzed the staff about precautions, which turned out to be even above and beyond what I would have expected. So yesterday I went for the tooth extraction and plug. After they put on the blood pressure cuff and put in the IV, I gradually got a little tired and closed my eyes. I sat there for about 10 minutes and thought Gee, I wonder if they're going to get started any time soon, and a minute later Dr. Amin said "Wake up, you're all done!" That was a short session, and I didn't have the kind of fatigue I did my first time. I stayed up most of the evening. Today, everything is good! I'm taking my antibiotic and eating soft foods, and there is surprisingly little pain now that the numbness has worn off. The tooth site and my cheek are a little sore, and the corner of my mouth, and I have a very slight headache, but nothing to any great level--I'm not even taking the acetaminophen. I feel good, and wide awake. Thanks to everyone at the office for a comfortable and professional job! I really REALLY appreciate you for giving me painless dental experiences!
Tanya S.
Tanya S.
December 3, 2020.
What can I say about Dr. Amin he is the best! I'm so grateful for him. He has literally changed my life and given me the confidence to smile more. I had major restorative dental work done and everything went smoothly. Dr. Amin is very compassionate and he really cares about his patients he made me feel comfortable and cared for. He is very knowledgeable and has a great sense of humor. His office is very clean and they take the patients health and safety very serious. His staff is also amazing they made me feel very welcomed and important. I'm so happy I did my research and found Dr. Amin.  Thank you Dr. Amin and team.
Sheila S.
Sheila S.
November 6, 2020.
Two implants done! Finished all procedures and I couldn't be happier. It's the first time in years I looked forward to going to the dentist. Even during Covid life the staff and Dr. Amin took care of me. There is a possibility I may move to Long Beach but I would still travel to keep Dr. Amin as my dentist.
Allison S.
Allison S.
November 4, 2020.
I could not ask for a more caring, exceptionally knowledgeable dental care provider. He's not just a dentist, but someone who looks after your immediate dental needs and helps you plan and prepare for the future.
Julia R.
Julia R.
October 8, 2020.
I've been going to Dr. Amin since I turned 16 and have been going since. Before going to Dr. Amin's dental office, I had 4 crowns that I was not happy with and dealt with it until finally I asked Dr. Amin and because I  feel comfortable and because I trust him with his work I recently had my crowns fixed and worked on by  Dr. Amin and have never loved my smile the way I do now, I can actually enjoy my pictures, I can enjoy my smile from either angle and that really mattered to me. Thank you so much Dr. Amin still and will be in love with MY smile
Aaron D.
Aaron D.
October 6, 2020.
I've been coming to Dr. Ramsey for about five years and I have to say, he is by far the best dentist I've had - ever. The staff is professional and kind, the office is exceptionally well maintained, and Dr. Ramsey is careful and extremely knowledgeable about current developments and research in dentistry. I recently had a dental implant which was a long process but well worth it. I required a sinus lift as well as a bone graft. The surgery went off without a hitch, I was comfortable and the healing process was quick and without complication. Highly recommend!!
Flo O.
Flo O.
September 21, 2020.
This is my 1st review of Dr. Amin, and in my over 17 years of being with him, my experiences with Dr. Amin and his staff have always been positive.  I don't recall a bad experience with the several implant procedures i have had.  They run an efficient office.  I like that they are proactive and reach out to their patients to remind us of routine care needed.  Dr. Amin's bedside care is impeccable.  They are also technologically up to date in terms of sending out texts as reminders, ability to incorporate any appointment into your mobile phone.  That is certainly a plus.  Keep up the great care!!!