A dental implant doesn’t bond to the gum; it bonds to the jawbone, and it’s this one fact that determines almost everything regarding the possibility of placing a tooth on the same day.

Most patients think that the decision comes down to how busy they are or how fast they would like to get the result. In fact, it’s the jaw that decides. In some cases, the jaw is ready for an implant as soon as a tooth is lost, while in others it has to be prepared first. Knowing the reason makes the talk with your dentist much more meaningful, particularly when the answer is “not today”.

Why bone decides the timeline

Same-day dental implants are based on a simple principle: if the implant can be inserted firmly enough so that it remains still while the bone grows around it, then a temporary tooth can be fitted immediately. But if it cannot be held firmly, putting a load on it too early would interfere with the healing process.

The stability of the implant is due to the bone that surrounds it; if there is sufficient height, adequate width, and a reasonable density, the implant makes a good hold from the very first minute, whereas if the bone is thin or soft, then the amount of grip is reduced and the treatment plan is adjusted accordingly.

What happens to bone after a tooth is lost

The jawbone’s purpose is to support the teeth; when a tooth is removed, the bone in that area gradually decreases in size since it no longer gets the stimulus of chewing.

The majority of this reduction takes place in the first year, the width of the ridge being affected before the height. That is the reason why a person who lost a tooth two months ago is usually a good candidate for immediate dental implants, whereas someone who has been missing the same tooth for eight years may need the bone to be rebuilt first.

People who wear dentures for a long time also show the same pattern. Since the denture sits on the gums and does not pass on force to the bone as a root does, the ridge below gradually becomes flatter over time.

Actually, age is not as important as most people think. A seventy-year-old with healthy bone can have an implant placed successfully, whereas a smoker in their thirties with untreated gum disease may have considerably less to work with. The dentist assesses the state of the bone, not the age shown on your record.

Primary stability explained

Primary stability refers to the mechanical hold that an implant has at the time it is placed, before any healing has taken place. It’s like a screw in wood; if you put it into solid timber it holds immediately, but if you put the same screw into soft chipboard it wobbles.

During the operation, dentists assess this grip. In that case, if the reading is within the acceptable range, a temporary tooth can be placed on the same day; but if it is below the required level, the implant is allowed to heal quietly under the gum for a few months before any tooth is attached to it.

The choice is reached in the chair on the basis of what the bone actually provides, and it may still change even if careful planning has already been done.

Situations that suit immediate placement

Immediate placement tends to work well when:

• The tooth has just been lost or is being taken out during the same visit.
• The bone is surrounded by intact tissue, with no active infection penetrating it.
• The bone height and width appear to be adequate in the scan.
• The gums are in good condition and do not have any untreated gum disease.
• General health remains stable, with diabetes and other conditions being well controlled.
• The patient either does not smoke or agrees to stop during the healing process.

Front teeth which have been broken as a result of trauma generally fall into this category because the bone surrounding them is usually in good condition.

Situations where waiting is the better choice

There are cases in which carrying out the implantation at once would affect the final outcome, and typical reasons for carrying out the treatment in stages are:

• Active infection at the site that needs to settle first
• Significant bone loss from long-term gum disease
• A tooth missing for many years with a noticeably shrunken ridge
• Very soft bone at the back of the upper jaw
• Sinus space sitting too close to the intended implant position
• Uncontrolled diabetes or other health issues that affect healing

To be asked to wait is not a disadvantage; it generally indicates that your dentist is aiming to ensure the desired result rather than rushing it.

Bone grafting and how it fits in

Bone grafting helps to restore the lost volume by having the material put into the area that is deficient, and then over a period of several months your own bone slowly takes over and replaces it.

This can be incorporated into treatment for implants in two ways. In most cases, small gaps around an implant can be grafted during the same visit, and this generally does not stop the immediate placement of teeth in Dubai. However, larger reconstructions, such as those involving sinus procedures in the upper jaw, usually need a separate healing period before an implant can be put in.

When your dentist has looked over the scan, they will tell you which category you belong in.

How your dentist assesses your bone

Since a standard dental X-ray only shows the height and gives very little information about the width, it cannot give an answer by itself; in most cases a three-dimensional scan of the jaw is taken, which enables the bone to be measured in all directions and allows the positions of the nerve and sinus to be determined.

The planning software will check whether an implant of a particular size can fit in the existing bone, leaving a safe margin on all sides, and your dentist will also examine your gums, look for any habit of grinding your teeth, go over your medical history and ask about any medications you are taking because some drugs can affect bone healing.

The definitive confirmation is only obtained during the operation, when the real grip of the implant is measured.

Looking after the bone you have

The way bone is treated affects it, and there are a few habits which can protect it.

• It is better to replace missing teeth as soon as possible because the shrinkage is most rapid during the first year.
• It is important to treat gum disease early since it causes the bone that supports the teeth to be destroyed.
• Cease smoking, since it decreases the blood supply to both the bone and the gum.
• Make sure that conditions like diabetes are well controlled.
• Make it a habit to have your check-ups regularly so that any problems can be detected early.
• Tell your dentist about the night grinding so that it can be dealt with.

Diet also has a modest influence since calcium, vitamin D, and overall nutrition contribute to bone health throughout the body, including in the jaw, which is why it’s worthwhile to mention a well-balanced diet together with brushing and flossing.

It’s not complicated at all, and everything you learn here gives you more choices in the future.

Takeaway

One day dental implants require bone that can securely hold the implant from the very first day; in most cases, recent tooth loss, good gums and sufficient bone volume mean that it is possible to carry out immediate placement, whereas in situations involving a long-standing gap, infection or considerable bone loss, a step-by-step method is usually needed.

You can find out which situation applies to you by having a scan and undergoing a proper examination. Ask your dentist to show you your own scan and to explain what the bone appears like. Most people then find the plan a lot easier to accept after they have seen the reason for it.

Contact them

Ready to take the next step? the Arjan team is happy to help.

• Magnum Dental Clinic – Arjan Address: Building 88, Al Barsha South, Near Miracle Garden, Arjan, Dubai, United Arab Emirates
• Phone: +971 55 890 8653

Robert Haynes, a psychology graduate from the University of Hertfordshire, has a keen interest in the fields of mental health, wellness, and lifestyle.