Same-day Dental Implants
Traditionally, a newly placed dental implant is allowed to heal and osseointegrate with the bone tissues in the jaw over the course of a few months without any disruption or further treatment.
However, in some cases it is now possible to for the process to be expedited and have a temporary prosthesis placed on the same visit as the extraction and dental implant placement.
Why Immediate Dental Implants?
Generally, same-day dental implants provide patients with a temporary dental prosthesis immediately during the same visit after having the damaged tooth extracted and dental implant fixture (screw portion of the dental implant that is screwed into the jaw) placed.
The benefits of same-day dental implants over conventionally placed implants are very clear. You won’t have to wear a removable denture to hide missing teeth and the same-day dental implant process requires the least number of visits to the dentist.
This method of placing dental implants is generally only used on suitable patients who are time-sensitive to the entire treatment of conventionally placed dental implants.
Immediate dental implants are usually recommended for patients who:
- Have damaged or missing front teeth
- Are worried about missing teeth
- Are time & cost sensitive
- Don’t want to undergo multiple dental surgeries
- Are looking to get All-On-4 Implants
- Are already completely edentulous
However, same-day dental implants process is still not completely seamless. You’ll still need to come back for a follow-up visit at a later date to get your permanent prosthesis fitted in place and you’ll need to make sure to avoid chewing with the area where the dental implant was placed.
In this article, we’ll look at the different types of retainers available to patients in Singapore and compare each of them.
Initial Dental Implant Consultation
It is important to note that the success of any same-day dental implant is highly dependant on the skills and expertise of the dental surgeon performing the procedure. This approach to placing dental implants is considered to be a highly technique sensitive requiring an expert dental implant team in order to be properly executed.
During your initial consultation, you’ll need to tell your dentist about your medical history and any existing health conditions or diseases that you may have, after which the dentist will thoroughly inspect your oral health through the use of dental x-rays and 3D imaging.
Through this in-depth analysis of your oral health, the dentist will determine if you are a suitable candidate for immediate dental implant surgery. Only certain patients and cases are suitable for same-day dental implant treatment as careful case selection, proper treatment planning and adherence of surgical and prosthetic protocols are key to the long-term success of immediate dental implants.
Once you’ve been deemed a suitable candidate for same-day dental implants, your dentist will then proceed to craft a customized treatment plan catered to meet your needs and requirements.
“Same-day dental implants” only means that the entire process for you will only take a single day. But for the dental team behind the scenes, it involves a detailed process of planning before the actual day of your surgery.
Once the treatment plan has been completed, you’ll be scheduled in for your actual surgery. Depending on the number of teeth that need to be replaced, you dentist will use one of three type of dental implant prosthesis.
Dental Implant Crown
Implant Supported Bridge
Dental implant supported bridges are used when there is a need to replace multiple sequential teeth at once.
This solution is commonly used as it’s a lot more affordable when compared to replacing everying single missing tooth with a dental implant.
A common dental implant bridge used by edentulous patients or patients looking to replace all of their teeth is the All-on-4 dental implant system.
An important thing to note about dental implant supported dentures would be the fact that they’re typically not removable once they’ve been placed unlike implant supported dentures.
Implant Supported Denture
This solution allows patients who are looking to replace all their teeth by utilising dental implants to retain and support a denture.
This type of dentures are a lot more comfortable when compared to regular dentures and are almost immovable and make biting and chewing feel as natural as possible.
Unlike implant supported bridges, this prosthesis option is removable. So patients can have to remove the prosthesis to have it cleaned every night.
Extraction & Dental Implant Placement
In the case where a tooth extraction is required, then it’s either done weeks before your surgery or on the day of your implant surgery. This decision is generally based on the amount and condition of the bone you have in your jaw, this will be detailed in the treatment plan as well.
The extraction process is typically done under local anaesthesia and is done carefully by gently manipulating the tooth until it becomes loose enough to remove. All infected tissue and bone is also usually removed during this process. The goal of any tooth extraction is to remove the tooth with as little disruption and damage to the extraction socket, surrounding gum tissue and adjacent teeth.
When done successfully, the tooth extraction process will allow for a smoother implant fixture ( titanium threaded screw shape post ) placement. This is especially important when the implant is going to be loaded immediately after surgery.
Dental Implant Surgery
The dental implant process can take a few hours if multiple implants are being placed. On the day of the surgery, you will be sedated using general anaesthesia or light local anaesthesia based on the number of implants that you’ll be getting that day.
However, this is mainly dependent on your pain tolerance and anxiety levels. Your dentist will recommend the best option based on your case.
Once you’ve been anaesthetized, the surgery can begin. Based on the complexity of your case, the surgical insertion of the dental implants will be done free-hand or with a fully customised digitally designed 3D printed surgical implant guide to help guide the dental implant in the correct position and angle during placement. The surgical guide are typically used for more complex cases as it enables the dentist to precisely place dental implants with a high margin of safety.
The dental implant site is then prepared and the dental implant is placed.
Once the dental implant has been placed, you’ll then be fitted with the dental prosthesis which will act as your replacement teeth (crown, bridge or denture). Depending on your case, the initial prosthesis fitted may only be temporary, while a permanent prosthesis will need to be fabricated. If this is the case, you’ll need to come back in a couple of weeks time to get the permanent prosthesis fitted.
The fitting of the prosthesis is an important part of the dental implant process as an ill-fitted dental prosthesis may potentially cause failure of the dental implants.
Healing and Checkups
Osseointegration and healing is a fundamental part of any dental implant treatment. This process allows the dental implants to permanently fuse to the jawbone, locking the dental implants in place. The osseointegration process will happen over the course of 4 – 6 month after your dental implant placement surgery. You will have to eat soft foods while this happens, especially during the first 8 weeks after you’ve gotten your immediate dental implants.
Moreover, you’ll still need to come back to the clinic in about a weeks time to get your final prosthesis and get your stitches removed.
After this, you will have another checkup so your dentist can make sure that your dental implants are secure and have properly osseointegrated with your jaw bone. Subsequently, your dentist will ask to see you once every 6 months, just to check and help maintain your dental implants.
|Immediate Dental Implants||Conventional Dental Implants|
|Cost of procedure||Generally more cost effective due to reduced number of visits.||Less cost effective due to the number of dental visits required.|
|Results||Patients can leave with a new set of teeth the same day as their surgery.||Patients will not leave the clinic with a new set of teeth. They will generally leave the clinic with a type of denture instead.|
|Treatment Duration||Surgery and prosthesis done in a single day. But patient will still need to come before for a consultation and treatment planning. As well as follow up checkups after the surgery. However, the entire process from initial consultation to a new smile will usually only take 2 weeks.||Entire process can take up to 6 – 8 months before patients can enjoy a new set of teeth. Some of these patients may have to go without dentition throughout this entire period.|
Only certain type of cases are suitable for immediate dental implants.
|The tested and proven ‘go-to’ method of placing dental implants. All cases are suitable as long as the patient is suitable for dental implants in general.|
|Success Rate||Risk of implant failure can be higher in some cases when compared to conventional dental implants.||95% Success rate|
“The success rate of any dental implant treatment is highly dependant on the patient’s compliance to the dentist instruction when it comes to postoperative care & maintenance of oral health”
Increased Risk of Implant Failure
The failure rate of a traditionally placed dental implant is generally about 95%. While the risk of failure when it comes to a same-day dental implant is significantly higher due to the increased risk of infection and failure to adequately heal and osseointegrate with bone.
Increased risk of infection
The risk of an implant infection is generally more prevalent in patients who have bad oral health or have some form of gum disease, which resulted in the need for dental implants in the first place.
Moreover, when an implant is placed into the socket of a severely decayed or infected tooth immediately after extraction, the risk of peri-implantitis afterwards is increased as there is a possibility that not all of the infected tissue has been thoroughly removed during the dental implant surgery. As such, most dentists would typically recommend a traditionally placed implant for these types of patients instead, as it allows time for the extraction socket to properly heal and rid itself of any infection.
Gum health and oral health is paramount when it comes to the long-term success of any dental implant treatment as such, most dentist would recommend all oral health issues (gingivitis and periodontitis) to be resolved prior to placement of dental implants.
Additionally, patients should keep with their routine dental care, which should include regular brushing and flossing at least twice a day.
Failure to osseointegrate
The risk of an implant failure due to the disruption of the osseointegration process is increased in immediate dental implants as the implants are immediately loaded with a prosthesis after the dental implant surgery. Freshly placed dental implants can be easily overloaded due to undue pressure on the dental prosthesis and abutment, which disrupts the process of osseointegration.
It is because of this very reason, that dentist typically only recommend patients get immediate dental implants for their front teeth and that patients should only eat soft foods for the first 2 months after their dental implant surgery to reduce the possibility of overloading the dental implants.
Smoking can cause implant failure
Smoking significantly increases the failure of any dental implant, and even more so in immediate dental implants. Patients who are avid smokers will be asked by their dentist to cease smoking during the entire osseointegration process which can take up of 6 months after the initial placement of the dental implants.
Heavily Reliant On Skills & Expertise
Any invasive medical treatments come with a certain level of risk. The success of any immediate dental implant treatment is highly reliant on the skills and expertise of the dentist performing the procedure. As such, it’s vital that you ascertain that the dentist and dental clinic that your considering, has all the necessary and relevant credentials.
Generally, we would advise patients to request before and after photos of the dentist previous immediate dental implant cases. This can be a good gauge and testimony to the skills of the dentist and post-operative care of the dental team.
Am I A Suitable Candidate For Same-Day Dental Implants?
As mentioned earlier in the article, only certain type of cases and patients are suitable for immediate dental implants. Dentists will typically conduct an extensive pre-surgical assessment before recommending immediate dental treatment.
Some of the main factors that dentists consider include:
- Which tooth needs to be replaced
- The amount and quality of jawbone
- Pre-existing medical conditions
- The existing oral health
- The patient’s compliance to instructions
The ideal immediate dental implant patient is someone who:
- has a healthy set of gums
- does not smoke
- is generally in good overall health
- only needs one or a few front teeth replaced or is already completely edentulous and needs their entire arch replaced with either an All-On-4 or a Implant retained denture.
If you’d like to check if you’re suitable candidate for immediate dental implants, do book an appointment with a team of dentists who are well-versed in dental implant surgery.
Same-day dental implants: new teeth in just 24 hours | Authority Dental
“Same Day Dental Implants: New Teeth In Just 24 Hours | Authority Dental”. Authority Dental, 2018, https://www.authoritydental.com/same-day-dental-implants. Accessed 26 Nov 2020.
Risk Assessment for Immediate Implant Treatment – Decisions in Dentistry
“Risk Assessment For Immediate Implant Treatment – Decisions In Dentistry”. Decisions In Dentistry, 2020, https://decisionsindentistry.com/article/risk-assessment-for-immediate-implant-treatment/. Accessed 26 Nov 2020.
AEGIS Communications. “The Myths & Realities Of Immediately Loaded Dental Implants | Inside Dentistry”. Aegisdentalnetwork.Com, 2020, https://www.aegisdentalnetwork.com/id/2008/09/the-myths-and-realities-of-immediately-loaded-dental-implants. Accessed 26 Nov 2020.
Urban, T., Kostopoulos, L. and Wenzel, A.
Urban, Thomas et al. “Immediate Implant Placement In Molar Regions: Risk Factors For Early Failure”. Clinical Oral Implants Research, vol 23, no. 2, 2011, pp. 220-227. Wiley, doi:10.1111/j.1600-0501.2011.02167.x. Accessed 26 Nov 2020.
Hassan Mohajerani, R. T.
Hassan Mohajerani, Reza Tabrizi. “The Risk Factors In Early Failure Of Dental Implants: A Retrospective Study “. Journal Of Dentistry, vol 18, no. 4, 2017, p. 298., https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5702435/. Accessed 26 Nov 2020.
Khorshid, Heba Ezzeldin A et al. “Complications, risk factors, and failures of immediate functional loading of implants placed in the completely edentulous maxillae: a report of 3 consecutive cases.” Implant dentistry vol. 23,2 (2014): 125-31. doi:10.1097/ID.0000000000000027
Khorshid, Heba Ezzeldin A. BDS, MS, PhD*; Hamed, Hamdy Aboul Fotouh BDS, MS, PhD†; Aziz, Essam A. BDS, MS, PhD‡ Complications, Risk Factors, and Failures of Immediate Functional Loading of Implants Placed in the Completely Edentulous Maxillae: A Report of 3 Consecutive Cases, Implant Dentistry: April 2014 – Volume 23 – Issue 2 – p 125-131 doi: 10.1097/ID.0000000000000027
Singh, Mayank et al. “Immediate dental implant placement with immediate loading following extraction of natural teeth.” National Journal of maxillofacial surgery vol. 6,2 (2015): 252-5. doi:10.4103/0975-5950.183864
Based on your needs and requirements, your dentist will recommend the dental implant solution for you.
Immediate dental implants are a viable solution to replace missing teeth for some patients but they are not without risks. Most dentists would still generally prefer to place dental implants the traditionally delayed method to better allows for osseointegration.
Ultimately, dental implants are a lifelong investment that will generally last patient a very long time as long as they’re well maintained and cared for. As such, all dentists would agree that the long term sustainability of any dental implant typically outweighs the short term benefits of a risky immediate dental implant placement.
Having said this, in certain situations, immediate loading of dental implants can be useful.
If you’re looking to understand more about dental implants in Singapore or looking to get your missing or damaged teeth replaced. Feel free to contact us to book an appointment with one of our esteemed dentists.
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A diastema is the medical term for a gap between two teeth. The most common type of diastema is a gap between the two upper front teeth, known as a ‘midline diastema’, but they can occur anywhere in the mouth.
Some people have just one noticeable gap, while other people have multiple teeth which look gappy and spaced out.