Same-day implants: when it works and when it does not

Placing an implant and a temporary crown in a single visit sounds appealing. Here is who the protocol suits and who is better served by the classic route.

Immediate implant placement means the implant goes in right after the tooth is removed, sometimes with a temporary crown fitted the same day. The patient leaves with a tooth in place rather than an empty socket.

When it is possible

The key requirement is enough bone of good quality and no acute inflammation at the extraction site. This cannot be judged by eye: a CT scan shows bone height, density and the position of important anatomical structures.

• the extraction is planned, not done during a flare-up
• the socket walls are intact and there is enough bone for primary stability
• no active periodontitis or untreated decay nearby
• general health allows for surgery

When it is better to wait

If there was a purulent process around the tooth, or the bone is thin or insufficient, rushing works against the result. In those cases we prepare the site first with bone grafting, let the tissue heal, and place the implant in a second stage. It takes longer but is far more predictable.

The difference between the protocols is not that one is more modern. Both have been used for decades, and the choice follows the scan and the clinical picture, not the wish to save time.