A single tooth implant is a permanent fixed replacement of a missing or broken down tooth. A titanium implant is inserted in the jawbone to serve as the anchor for the replacement tooth (a crown).

It is often advantageous to insert the implant at the same time as the extraction of the tooth, this is called ‘immediate placement’ of the dental implants. Usually the titanium fixture would be allowed to heal under the gum for approximately 3 months, or longer if any sort of grafting or tissue reconstruction was required, before the crown can be fitted.

However, in some cases it is indeed possible to fit an immediate replacement tooth to the titanium insert, thus loading the implant, which is called ‘immediate loading’ of the tooth implant.

Immediate placement

Immediate placement involves a process whereby, in the first instance, the tooth is removed and its residual socket is cleaned from any infection or debris in preparation for the fixture placement.

The bone integrity of the site is then assessed and a decision is made as to whether the tooth implant can be placed at that time, with or without additional tissue augmentation, or whether the socket should be allowed to heal before placing the titanium fixture.

A bone graft and/or gum graft may be required when there are additional risk factors present for recession or failure of dental implants that may affect the aesthetic outcome. Bone grafting may be required when the outer aspect of the bone socket is very thin after the extraction, or when the size of the socket is much larger than the size of the titanium insert.

A bovine bone mineral is often used to fill the residual gap and thicken the bone, whereas a gum graft may be indicated when the gums are thin, dark or transparent. The gum graft thickens up the soft tissue and improves its resistance to recession. Whatever procedures may be required, these are often done in the same visit. It is important to address any such issues, especially with the single tooth implant, because dental implants treatment cannot be easily undone, and we often need to resurrect a compromised site to achieve the best possible aesthetic result .

Immediate loading

Immediate loading can be performed when a suitable implant type is used, and when sufficient stability can be achieved at the time of surgery. When attaching an immediate crown, we still need to respect the biological process of osseointegration, the bonding of the jawbone to the titanium insert that supports the crown, which takes 2-3 months. We do so by making the crown slightly shorter to reduce the biting pressure, and also by asking the patient to avoid biting on their immediate tooth implant. The final porcelain crown is attached to the titanium post once it has bonded with the bone.

Earlier extraction

To replace a single missing tooth where the extraction took place sometime earlier, we apply the same principles to assess the risk factors and determine whether bone or gum grafting is required, and whether an immediate crown can be fitted at the same time as the placement of the dental implants.

For more information on dental implants and to discuss options for a smile makeover, book an appointment with a dentist at CAID – call (03) 8845 5400 or contact us online.