Definition
ICOI defines immediate implant placement as placing a dental implant at the time of tooth extraction, into the extraction socket.1 It is different from immediate loading, which is about when the tooth goes on.2
Placement and loading combined
An ITI systematic review (2018) sorted cases by both timing choices: when the implant is placed (immediate, early or late after extraction) and when it is loaded (immediate, early or conventional).2 It analyzed 69 publications on people missing some teeth, including 15 randomized controlled trials, 7 controlled clinical trials and 47 cohort studies.2 Each study needed at least 10 cases and 12 months of follow-up.2
| Placement | Loading | Weighted survival | Evidence level |
|---|---|---|---|
| Immediate | Immediate | 98.4 percent | Clinically documented |
| Immediate | Early | 98.2 percent | Clinically documented |
| Immediate | Conventional | 96.0 percent | Scientifically and clinically validated |
| Late (healed site) | Immediate | 97.9 percent | Clinically documented |
| Late (healed site) | Early | 98.3 percent | Scientifically and clinically validated |
| Late (healed site) | Conventional | 97.7 percent | Scientifically and clinically validated |
The study designs varied too much for a combined meta-analysis.2 The review concluded that the loading protocol appears to influence the outcome of immediate placement.2
Planning
The ITI Group 2 consensus (2018) states that placement and loading protocols should be considered together when planning treatment.3 When the implant is not placed right away, the socket heals first; bone changes after extraction are largest in the first 3 to 6 months.4
Questions to ask
- Is the implant going in the day the tooth comes out, or after healing.
- Will a tooth be attached the same day, and is it for appearance or chewing.
- Is grafting planned for the socket.
General information about dental implants. Treatment decisions are made with a licensed dentist.
Sources
- ICOI Glossary: Immediate Implant Placement. icoi.org
- Gallucci GO et al. Implant placement and loading protocols in partially edentulous patients: systematic review. Clin Oral Implants Res 2018. pubmed.ncbi.nlm.nih.gov
- Morton D et al. Group 2 ITI Consensus Report: Prosthodontics and implant dentistry. Clin Oral Implants Res 2018. pubmed.ncbi.nlm.nih.gov
- Tan WL et al. Post-extraction alveolar hard and soft tissue dimensional changes: systematic review. Clin Oral Implants Res 2012. pubmed.ncbi.nlm.nih.gov
