Timeline for Implant Placement: Do I Need to Wait for Complete Healing of the Site?

Dr. B. asks:
I have a middle-age female patient who had her #7 [maxillary left central incisor] extracted one week ago by another dentist. The extraction was basically atraumatic and went well. The alveolar ridge and buccal plate are intact and the area is healing well. She wants me to place an implant and crown as soon as possible. Can I place the implant now or do I have to wait 2-4 months for complete healing of the site? I will be placing a Nobel Biocare Replace tapered 3.5 x 10 mm and then I will then place a temporary abutment and temporary crown. What is the best possible treatment plan here?

9 thoughts on “Timeline for Implant Placement: Do I Need to Wait for Complete Healing of the Site?

  1. Peter Fairbairn says:

    If no acute infection or no buccal defect ( if so must graft) place NOW in 2-4 months you will have a big concavity to deal with , up to 50 % of the palato-buccal with can be lost , 50% of that in the first month (Tarnow and Small). As for iimmediate loading beware of protrusive movements ,as this is a referral case to you be careful with taking risks (immediate load).

  2. Dr. D. Stall says:

    Do it now, if no infection, but use a longer implant. I had a similar situation with a new patient having had #4 removed 3 weeks prior to coming to my office. I did the implant the next week. I took the transfer impression today. Just do it.

  3. dr rabbani says:

    well its better to do it now but use slightly wider diameter implant as central incisor leaves a wide socket.make your prosthesis in occlusal relief so no masticatory loads can alter the healing.good luck

  4. David Levitt says:

    I assume you mean #7 LATERAL incisor. First use a longer implant. Second do not do the procedure if there was any chronic infection around the extracted tooth as the mature thrombus at 14 days is a wonderful culture medium and you most likely have quite a bacteremia in the area. Why didn’t you just place the implant at time of extraction?

  5. Dr Sumeet Sherwani says:

    I would reckon to do it now. I have been using an IMplant called BCS(BI COTICAL SCREW) by IHDE DENTAL, it gives good initial stability. I have used BCS Implants with length of 17mm in cases of immediate extraction in lower anteriors. Its one piece implant,so you can give crown the same day. Keep the crown out of occlusion for atleast 3 months, then give permanant functional crown

  6. Barry Hoffman, Prosthodontist says:

    Dr. B,

    Your basic problem is not early loading vs. delayed loading. The universal question you are asking is “When is my implant stable enough to start loading”? No two situations are ever equal. We deal with many variables such as: cortical bone thickness, D-1 thru D-4 bone density, thread design on the implant, bone stress at time of surgical injury, grafting issues, implant diameter/length, implant placement depth, and on and on and on….

    The gold standard of waiting 3 months in the mandible and 6 months in the maxilla seems to be overly conservative from recent research. Implant stability at time of placement is greater than it is 4 weeks post surgery. So how do you know when it is safe to restore, whether with a temporary or permanent restoration? Torque testing the implant used to be a measure for decision making. However, if you torque tested the implant too soon, you ran the risk of creating a “spinner” and immediate failure if the integration process hadn’t created sufficient resistance for the test.

    Today, there are non-invasive methods for determining implant stability. Osstell is a company that makes an Implant Stability Analyzer. Through the process of magnetic resonance, the system determines an implants stability at any phase of the process after insertion. It will give an objective measure for when restoration may safely be considered. The systems results also provide uniformity between implants in the same patient and between patients. Non-invasive systems such as this will eventually become the standard of care for determining when to restore an implant. Ideally, it will be used by the surgeon at the time of implant placement and later, prior to recommending to the restorative dentist on when to proceed.

    Take the guess work out of it. Use a documented non-destructive device for implant stability determination and sleep comfortably at night.

Leave a Comment:

Comment Guidelines: Be Yourself. Be Respectful. Add Value. For more details, read our comment guidelines. Though we require an email to comment, we will NEVER publish your email.
Required fields are marked *

Posted in Clinical Questions, Immediate Loading, Surgical.
Bookmark Timeline for Implant Placement: Do I Need to Wait for Complete Healing of the Site?

Videos to Watch:

Suturing in Guided Bone Regeneration

This video provides clinical tips for suturing techniques in Guided Bone Regeneration. In Guided Bone[...]

Watch Now!
Socket grafting with Collagen Dressing and Bond Apatite

This video demonstrates socket grafting with just bond apatite and a collagen wound dressing.[...]

Watch Now!
Dental Implant for Lower Right Second Molar

This video shows implant placement on the lower right second molar.[...]

Watch Now!
Saving a Bridge with Periodontal Therapy

This video shows a case involving a 48-year-old male who was referred for periodontal treatment[...]

Watch Now!
Immediate Loading Full Arch

This video shows a case of Immediate loading of a full arch with simultaneous guided[...]

Watch Now!
Apically Repositioned Flap Technique Around Implants

The apically positioned flap is a commonly used surgical approach, that may help the long[...]

Watch Now!
Digitally Planned Bone Augmentation and Immediate Implantation

This video shows a case using the Ring technique to provide bone augmentation along with[...]

Watch Now!
AnyRidge Implants: Replacement of Upper Left Molars

This video shows the replacement of maxillary upper left molars with Megagen AnyRidge Implants.[...]

1 Comment

Watch Now!
Guided Implant Surgery & Immediate Temporisation

This video demonstrates the placement of a missing pre-molar using computer-guided surgery and immediate temporization.[...]

1 Comment

Watch Now!
Implantoplasty to Treat Peri-implantitis

This video shows the use of the Implantoplasty technique to treat peri-implantits. Granulation tissue and[...]


Watch Now!
Placement of Implant Using EZ Devices

This video demonstrates the placement of a dental implant in the upper jaw using the[...]

Watch Now!
BonePen: Improve Positioning of Implants

A short video demonstrating close up the use of the BonePen Kit, a set of[...]

Watch Now!