It is now considered that the most ideal time to place an implant is immediately after a tooth is extracted, i.e. at the same appointment. Once a tooth is removed the bone underneath the space quickly starts to resorb. This can cause future problems for implants as too little bone may be left remaining to support an implant. Thus if placed immediately at extraction, and before any bone resorption has occurred, the maximum amount of bone (and hence the greater chance of a good successful result) will be available. There are also the cosmetic advantages of a better emergence profile and preservation of the papilla.
It has been only recently that modern advances in implant technology have made immediate implant placement possible. Another big advantage with immediate implants is the improvement in patient comfort. As the implant is placed at the same time as the tooth is extracted there is no need for any further surgical procedure for the implant insertion.
In some circumstances such as infections, cysts or where insufficient bone is already present around a tooth due for extraction, an immediate implant may not be possible.
If a patient does require the removal of a tooth it is important not to delay in the decision about whether to have an implant or not. The sooner a doomed tooth is removed and an implant placed, the less chance that an infection or other potential problem may occur in the meantime.
On rare occasions, even after careful planning with radiographs and/or scans, we may find that once the tooth is removed an immediate implant may not be possible after all, due to poor remaining bone support or infection. In these circumstances the bone must be allowed to heal either with or without the aid of a bone graft for 3-6 months whilst new, healthy bone regrows into the area.