Implant treatment confusion: Immediate or Wait?

Not much in dentistry is black and white. I prefer to place titanium same time as extraction. Certain factors apply of course. I am in no way right or wrong, it's just my opinion and the way I choose to do this. I will also place temp crowns day of in most cases. I would ask around look online and go for the doctor you feel is most qualified to do this and follow their reccomendations. There is a saying in dentistry "patient driven treatment plans rarely work" if you have to wait then wait. If you get it done immediate great just trust the person you choose and follow their reccomendations

IMHO when there is failing endo you runa higher risk doing an immediate implant. I would extract the tooth currette the socket fill with graft place the patient on antibiotics wait 406 weeks then place your implant trying to use a fixture that is longer then the current root length to its in good bone. To temp it make the patient an essix temp they are much better tolerated then a flipper

We also have to think that it is going to be in the aesthetic zone, looks like it is an upper lateral incisor , immediate placement is great but there is always risk of bone loss and exposure of implant and this being in the aesthetic zone would be catastrophic .

There are a number of factors that will have to be taken into account regarding Immediate Vs Delayed placement. Factors such as your expectations, your age, health, habits (smoking), your smile line and lip line, your tissue quantity and quality (biotype), the position of the root (Facially / Palatally) in the bone, the amount of bone above the root, your occlusion (bite relationship between upper and lower jaw), the endodontic situation (taken into account) and if this implant is right next to one of the other Implants you mentioned having had placed. All of these factors are usually taken into account when deciding on whether to do an Immediate Vs. delayed. You will get some level of gum recession in the area even with a graft but it is important to limit the gum recession and avoid bone recession. The most important thing is that your treatment plan is evidence based (Ie: based on most current research) and not convenience based. Dont' fall into the trap of thinking faster is better for you. while you might very well be able to do an immediate in this situation you may also end up with some serious aesthetic issues down the road if your situation is not ideal for Immediate placement. A few extra months of treatment initially may save you a lot of issues later on.

I appreciate all the feedback! Its just a hard decision as I just recently went through a 9 month treatment plan for the tooth next to it. (extraction, bone grafting, implant placed) The dentist that performed this tooth is recommending the same treatment plan for this one but I did get a second opinion from a Dr Jay Beagle in Indianapolis who said there is no issue with doing an immediate implant. So I have conflicting opinions and knowing I can cut the treatment time nearly in half and no flipper it's hard to not consider that. I do understand the value of getting this right and not having to worry about it down the road, I am a healthy non smoking 34 yr old male and have had no issues with my previous 2 implants. My main hangup is trying to avoid the flipper or an essex appliance as I have done that twice before and being in Sales and speaking with people and lunches its hard to wear those in my position. From my own research it seems that my greatest risk with the immediate implant is not properly cleaning the implant site infection before placement, if I went with route one and it wasn't fully cleaned before bone grafting was placed would that be an potential problem with that method too? I appreciate everyone's opinions and am looking for the best plan for me. Thanks

I do not place implants into pools of sepsis like this case. Even curetting the socket is not a 100% guarantee of preventing contamination of your implant and surrounding bone. Time is always an inconvenience for sure, but a failed implant may do damage that will result in lots of time being spent correcting the situation. Just my thoughts and I respect those we think differently.