What is the indication for #8 immediate implant after extraction

DISCUSSION

These findings have important clinical implications for treatment planning. Clinicians should consider immediate implant placement as a preferred option when adequate primary stability can be achieved, particularly in patients who are concerned about treatment duration, aesthetics during healing, and maintaining social function. Long-term success of implant therapy requires systematic monitoring using validated diagnostic measures and standardised radiographic assessment protocols to ensure optimal peri-implant health and early detection of potential complications.10,34 The comparable survival rates combined with superior secondary outcomes suggest that immediate placement offers a favourable benefit-to-risk ratio in appropriately selected cases. Patient counselling should emphasise the potential advantages of immediate placement, including reduced treatment time, better preservation of alveolar bone dimensions, improved aesthetic outcomes, and enhanced quality of life, while acknowledging that both approaches are effective. For cases where immediate placement is technically feasible and adequate primary stability can be obtained, the evidence from this study supports its use. Conversely, delayed placement remains an appropriate and successful approach when anatomical or clinical conditions do not favour immediate placement. Future treatment algorithms may incorporate patient preferences for treatment duration and aesthetic concerns during healing as important factors in the decision-making process.

Impact of Immediate vs Delayed Dental Implants on Survival, Patient Satisfaction, and Quality of Life. © 2026 by Quintessence Publishing Co Inc. Creative Commons Attribution 4.0 International (https://creativecommons.org/licenses/by/4.0/).

Introduction

In recent decades, dental implants have become a reliable treatment for tooth loss. Immediate implant placement, has become the preferred treatment for patients needing upper anterior teeth extraction due to trauma or caries. This approach restores aesthetics and function in a shorter time frame, avoiding the trauma of a second surgery post-extraction and preserving the width and height of the remaining alveolar bone (1). The accurate three-dimensional position of the implant is an absolute prerequisite for immediate implantation in the aesthetic zone. The unpredictability of soft and hard tissue reconstruction during immediate implantation increases the aesthetic risk. It is crucial to determine the implant placement based on the BBW thickness and anatomical morphology after tooth extraction.

Morphology and thickness of the buccal bone wall of the maxillary central incisors in population: a CBCT study. © 2024 Song, Yang and Wang. Creative Commons Attribution 4.0 International (https://creativecommons.org/licenses/by/4.0/).

Discussion

In addition to general considerations, the positional rationale concerning the location of implant placement also needs to be addressed. For immediate implant placement in the maxillary anterior region, factors such as a single tooth socket with thin buccal bone, high esthetic demand, and the relationship with anatomical structures (nasal floor, nasopalatine canal, hyper-pneumatized maxillary sinus) are major concerns. The adequacy of facial bone thickness (≥ 1 mm) and apical bone (≥ 5 mm) should be assessed before deciding on immediate placement. Subsequently, palatal positioning of the implant in relation to the extracted socket, with an at least 2 mm gap between the implant and facial bone with bone graft during flapless extraction enhances esthetic outcomes [20]. A single- or double-rooted maxillary premolar area, particularly when dealing with relatively low bone quality, can pose challenges, especially in cases of maxillary sinus hyperpneumatization. In our present study, the premolar region exhibited significantly high survival rates (100%), emphasizing the importance of adhering to general considerations for implant placement and appropriate choices regarding implant diameter and length.

Long-term survival rates of tapered self-tapping bone-level implants after immediate placement: a positional effective rationale. © The Author(s) 2024. Creative Commons Attribution 4.0 International (https://creativecommons.org/licenses/by/4.0/).

Introduction

Immediate implant placement is an alternative technique to the conventional one-stage and two-stage techniques [1, 2]. Immediate implant placement minimizes bony contour and soft tissue alteration, preserves bone volume, allows for greater ease in determining the implant position for rehabilitation of the final restoration, minimizes the extent of alveolar bone loss after extraction [3–5], decreases the number of surgeries, reduces treatment time, and provides faster recovery of dental functions [6, 7]. However, case selection must be done for the immediate implant placement. The considerations for immediate implant placement are as follows: (1) medical status of the patient; (2) bony plates remaining in the socket; (3) intraradicular septum in multiple root sockets; (4) amount of apical bone; (5) diagnosis of the tooth, and (6) soft tissue health [8, 9].

Clinical outcomes of 3–5 years follow-up of immediate implant placement in posterior teeth: a prospective study. © The Author(s) 2024. Creative Commons Attribution 4.0 International (https://creativecommons.org/licenses/by/4.0/).

Discussion

Success of an immediate implant depends on the primary stability acquired from apical and lateral bone [17]. The clinical result is highly predictable when the ideal conditions for immediate placement are met. The general considerations for successful immediate implant placement are an extraction socket free of acute infection, atraumatic extraction with a flapless procedure, intact facial bone with sufficient thickness (1.5 mm), availability of > 5 mm basal or palatal bone to allow primary stability, three-dimensional implant positioning in relation to existing socket morphology, a sufficient gap between implant and facial wall (> 2 mm), and choice of implant according to location and availability of bone.

Long-term survival rates of tapered self-tapping bone-level implants after immediate placement: a positional effective rationale. © The Author(s) 2024. Creative Commons Attribution 4.0 International (https://creativecommons.org/licenses/by/4.0/).

Abstract

PURPOSE: The aim of this review was to evaluate the clinical outcomes for the different time points of implant placement following tooth extraction. MATERIALS AND METHODS: A PubMed search and a hand search of selected journals were performed to identify clinical studies published in English that reported on outcomes of implants in postextraction sites. Only studies that included 10 or more patients were accepted. For implant success/survival outcomes, only studies with a mean follow-up period of at least 12 months from the time of implant placement were included. The following outcomes were identified: (1) change in peri-implant defect dimension, (2) implant survival and success, and (3) esthetic outcomes. RESULTS AND CONCLUSIONS: Of 1,107 abstracts and 170 full-text articles considered, 91 studies met the inclusion criteria for this review. Bone augmentation procedures are effective in promoting bone fill and defect resolution at implants in postextraction sites, and are more successful with immediate (type 1) and early placement (type 2 and type 3) than with late placement (type 4). The majority of studies reported survival rates of over 95%. Similar survival rates were observed for immediate (type 1) and early (type 2) placement. Recession of the facial mucosal margin is common with immediate (type 1) placement. Risk indicators included a thin tissue biotype, a facial malposition of the implant, and a thin or damaged facial bone wall. Early implant placement (type 2 and type 3) is associated with a lower frequency of mucosal recession compared to immediate placement (type 1).

Abstract

PURPOSE: In dental implant treatment, ridge preservation and immediate or early implant placement are recommended to minimize bone resorption after tooth extraction and achieve esthetic outcomes. However, there is no consensus concerning the efficacy of this surgical method. There is also no consensus on the efficacy of bone and soft tissue grafts and surgical methods for alveolar ridge reconstruction. STUDY SELECTION: This paper reports ridge alteration in the anterior maxilla after tooth extraction, and summarizes the efficacy of various ridge preservation methods and immediate or early implant placement as alveolar ridge preservation methods to minimize bone resorption after tooth extraction. The advantages and complications of alveolar ridge reconstruction methods, and the efficacy and surgical method of soft tissue graft are reviewed. RESULTS: The anterior maxilla is in the esthetic zone, and the thickness of the bone on the labial side around the natural tooth is less than 1mm in many cases. Therefore, it is impossible to prevent bone resorption completely, even if ridge preservation and immediate or early implant placement are performed after tooth extraction. It is necessary to obtain stable and long-term esthetics by combining connective tissue and free gingival grafts, in addition to hard tissue augmentation. CONCLUSIONS: It is important to consider the burden and level of satisfaction of patients, such as in terms of donor site morbidity in hard and soft tissue grafting, and to pay attention to appropriate indications to avoid overtreatment.

Abstract

The anterior maxilla is the most traumatized region during childhood. Posttraumatic complications occasionally lead to tooth loss as well as the need for future implants. Unfortunately, it is contraindicated to place dental implants during childhood. A waiting period of approximately 8 to 10 years before completion of growth is required. For this patient to become a candidate for future dental implants, it is necessary to ensure the continuous growth and to preserve the dimensions of the alveolar process until growth has ceased from time of injury until joint maturation. To achieve these goals, it is essential to coordinate the treatment sequence at the time of trauma. After loss of a traumatized anterior permanent maxillary incisor in young adults, treatment options are limited: orthodontic closure of the gap and reshaping the adjacent teeth, or tooth extraction and maintaining the gap with a temporary restoration. Orthodontic space closure has limited indications and requires prosthetic restoration of at least 2 teeth. Extraction and temporary restoration will usually lead to bone augmentation before implantation. Other possible treatment options include orthodontic extrusion of the root remnant (in cases of untreatable root fracture or complicated crown-root fracture) and a temporary crown to serve the patient until the completion of growth and development, autogenous tooth transplantation, intentional extraction and immediate tooth replantation, distraction osteogenesis, and decoronation. Because general rules do not apply, individual treatment plans are necessary.