This summary is based on the article published in the International Journal of Oral Implantology and Clinical Research: Mesiodistal Bone Loss of Fresh Socket Placed Implants and Delay Placed Implants at the Anterior of the Maxilla (May-Aug 2013)
Context
Immediate implant placement in fresh extraction sockets provides the advantage of shorter treatment time along with minimizing the number of surgical interventions.
Purpose of the Study
To compare the amount of mesiodistal bone loss of fresh socket placed implants and delay placed implants at the anterior of the maxilla.
Key Messages
- Comparison of marginal bone loss in fresh socket placed implants and delay implants did not show a significant difference. Also a continuous bone resorption was observed over the time in the both groups.
- The amount of bone loss was not different between a delay placed implant and a fresh socket placed implant in the same conditions.
- Placing the implants in a lingual position into the extraction socket, the large buccal gap that occurred between the titanium device and the bone wall during healing became filled with bone. The implant thus became fully integrated into bone.
- In fresh extraction socket implants, the width of the gap between the implant surface and the bone walls at the time of implant placement
- represents a critical point for bone healing, since as the gap widens, the amount of bone-implant contact decreases, and the point of the highest bone-implant contact shifts apically.
- It may be needed to investigate other success criteria in fresh socket placed implants for making an appropriate treatment plan.
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This is not a hard and fast rule but more of an observation. The loss of the coronal 1 mm of bone is often lost after immediate implant placement due to the loss of vascular supply from the PDL. Also, the thickness of the cornonal portion of the alveolar socket will influence the resorption of the crestl wall. This article will lead to novice dentists getting into a lot of revision surgery/complainst when three years later their patients return to ask “why is my gum blue below my crown”
I agree that it is not that simple but in general the immediate placement concept is a good one and specialized forms of different implants can be considered. Implants come in many shapes and sizes and if one uses implant that taper, have wider platforms, bigger sized, angle corrected heads, etc. one can further minimize the bone changes and positively affect the outcome.