Unitary immediate implant (to put back a single tooth)

Background and details

The place of a immediate implant post-extraction is a situation with a very good functional result but with a somewhat unpredictable aesthetic result, especially in the long term. Following dental extraction, a reabsorption of the external bone cortical occurs, especially of the cortical. vestibular (front) both thick and high, leading to a decline in thickness and height of the contour of soft tissues.

Studies in animals and humans have determined that bone remodeling after extraction is unchanged by an implant placement. That's why the immediate implant involves a risk. esthetic as a mean central gingival margin recession of more than 1 mm or 10-35% of crown length has been observed in patients treated with this modality in patient-controlled studies.

Nevertheless, immediate implant have the advantage of better conservation of Gingival papilas (triangles of gums between teeth and teeth), as if the gums are not lifted to place the implant, the papilla will be better preserved than if the implant was put into a deferred protocol (both the gums).

The placement of an immediate implant from a three-dimensional point of view is more difficult than conventional placementas the pallatin wall of the post-extraction alveole and the space that remains between the implant and the vestibular wall of the bone have to be filled with bone graft material (whether autogenic or xenograft) to ensure complete bone cover of the implant after scarring.

Following placement of an immediate implant a provisional crown is usually placed that will allow an appropriate aesthetics on the same day but that will have to be subjected to no functional loads (biting solid foods). That crown after a minimum time of 3 months have to be replaced by a final crown.

The function of the immediate crown as well as the obvious aesthetic function, is to contribute to the seal of the alveolo as well as to provide support to the gum preventing its collapse.

The immediate implants may be used only in cases where there is no active infection and when there's integrity of the walls of the alveolo, especially of the vestibular wall that's the most critical and the one with the most reabsorption after extraction.