We do offer ‘teeth in the same day’ treatment when appropriate. This means the teeth extraction, placement of dental implants, and the temporary restorations can all be done all in the same day providing you with the benefits of immediate function and aesthetics.
What is Teeth-in-A-Day?
Teeth-in-A-Day is a treatment approach that consists of extraction of teeth, placement of implants, and the restorations, all on the same day. Our current technology and techniques makes this a reality in today’s dentistry. Patients can come in the office in morning with no teeth or failing teeth and leave with implants and teeth on the same day. Teeth-in-a-Day consists of placing an implant following teeth extraction(immediate implant) and restoring it with teeth immediately (immediate restorations). If teeth have already been extracted previously, then implants are placed routinely and restored on the same day.
Teeth-in-A-Day treatment, while possible and attractive, has become a widely used marketing tool to attract patients. Unfortunately there are a lot of misleading information and it is advisable for patients to make more informed decisions by asking the right questions.
When Are Immediate Implants Possible?
- Immediate implants are most predictable when they are placed in single rooted teeth. These include incisors, canines, and some premolars. They should be avoided in the molars due to the risk of increased complications and failure.
- The bone surrounding the extracted tooth which will support the implant must be intact with no major bone loss or defects. In this case, it is best to graft the site, restore the bone and place the implant later, once the graft has healed.
- There should be no infection or pus present. Placement of implants in a site with infection has high failure rates and will not heal properly.
- The diameter of the extracted tooth should be relatively smaller than the implant being used. This is important, because proper implant healing requires direct contact between the implant and bone and good stability. If the implant is loose in the extracted site, it will fail.
When Are Immediate Restorations Possible?
Immediate restorations refer to the situation in which a temporary restorations in form of a crown, bridge, or denture are placed on implants on the same day. Obviously, the advantage of this treatment is a patient having teeth right away, supported by the implants, providing them with good aesthetics and perhaps function and avoiding use of other forms of temporary teeth such as a removable flipper. But it is important to realize that immediate restorations, while successful, should only be considered in certain situations. Otherwise, they will result in implant failure and loss. Here are the general principles for immediate restorations:
- The oral surgeon placing the implant will inform the restoring dentist whether the implant is stable enough for restoration on the same day. If not appropriate, then the implant should be allowed to heal first and with the restoration placed at a later time.
- Immediate restorations are most predictable when they are placed as multi-unit bridges or dentures on several implants.
- In the case of single implants, the temporary crown should be placed with caution and if possible, bonded to adjacent teeth for additional support. The key is to avoid excessive forces on the implant during its healing
- The implants must be very stable in the bone. If the bone is soft or implants are not very stable, then placement of immediate restoration can cause them to fail.
- The immediate restoration is for the most part for cosmetic purposes. Patients must adhere to a very soft diet during healing and avoid excessive forces on the implants and its restorations. The restorations should clear the bite, so that they do not touch the opposing teeth.
- Once the immediate temporary restoration is placed, it should be left alone during the entire healing phase (3-6 months). Any manipulation during early phases of healing will result in failure and loss of the implants. When appropriate, the temporary restorations may be adjusted as needed to help shape the surrounding gum tissue for a better aesthetic and functional result.
In summary, immediate restorations may be placed if:
- Implants have great stability (tight in bone)
- There are multiple implants being splinted together during healing
- Biting pressure can be avoided during the healing phase
- The restoration is used mostly for cosmetic purposes and not to chew
- Implants are given adequate healing time before being manipulated
Teeth-in-A-Day May be Considered If:
- Implants are placed in single rooted teeth immediately following extraction
- There is no infection
- There is adequate bone present
- The implants can be placed with good stability
Teeth-in-a-Day Should be Avoided If:
- The extracted sites planned for immediate implant are molars
- There is significant infection
- There is deficiency of existing bone
- The implants can not be held tightly in the bone because of the wide diameter of the extracted teeth
- The implants are unstable for any reason