Dental Implants

What's New in Implants

Placing Temporary Teeth on Implants the Same Day as the Implant is Placed

In 1969-1970 the original technique for placing dental implants advocated by Branemark dictated that the implant sit undisturbed for a period of healing that ranged between 3 and 6 months to insure consistent bone-to-implant adaptation.

Over that same time period. Branemark, as well as other authors and researchers, have suggested that the healing period is dependent on a number of factors such as quality and quantity of bone, implant surface design, surgical technique, medical conditions and the healing potential of the bone in the site of the implant. As with all areas of science and medicine, we continue to challenge what we think we already know and we “press the envelope” of what is possible in order to progress forward.

Over the past several years, efforts to shorten the healing period for implants have been investigated. Many articles have now been written that describe cases where implants have been placed and temporary teeth have been attached to the implants the same day. The synopsis of the article below is one such example of how we are creating new possibilities for implant placement. Please keep in mind that this approach to the placement of implants is not a “one size fits all” solution and may only be appropriate in very select situations.

Immediate Provisional for Single-Tooth
Implant Replacement with Branemark System:
Preliminary Report

Edward Hui, MDS, MBBS, FDSRCS, FRCDC; James Chow, MDS, MBBS, FDSRCS, FRCD

Abstract

Background: The success of osseointegrated implants for single-tooth restorations is documented. Future developments should aim at improving the benefits to patients by decreasing treatment time, minimizing surgical stages, and maximizing esthetic outcomes. Using knowledge from studies of immediate implant placement, one-stage, immediate loading protocols, the authors developed the immediate provisional.

Purpose: The purpose of this study was to develop a protocol to provide an immediate solution for restoring a single missing tooth in the esthetic zone. The protocol should be simple, predictable, cost effective, and allow the use of other techniques to improve esthetic outcome.

Materials and Method: This prospective clinical study included 24 patients treated from August 1999 to October 2000. Single-tooth implant replacement was done according to immediate provisional protocol. Thirteen of the 24 patients had immediate implant placement after tooth extraction. All implants were placed in the esthetic zone. During surgery, emphasis was placed on obtaining primary stability by achieving bicortical anchorage and maximum insertion torque of at least 40 Ncm. CeraOne (Nobel Biocare) abutments were used, and provisional crowns were fabricated immediately before wound closure. The occlusion was protected by adjacent teeth.

Results: Within the follow-up period of between 1 month and 15 months, all fixtures in the 24 patients were stable. Crestal bone loss greater than one thread-width was not detected. The esthetic result was considered satisfactory by all patients.

Conclusions: The implant placement and restoration protocol used in this study showed promising initial results for both the immediate implant and healed extraction site groups. The desirable goals of patient satisfaction, excellent esthetic outcomes, and no increase in treatment cost were achieved in this protocol. Further studies to elucidate the potential of the immediate provisional protocol are justified.