Immediate Implants. Pros and cons!

We are witnessing a typical case scenario where a front tooth is faced with an unpredictable situation. Conventional dental treatment would not serve this situation in a predictable manner.

What this means is an investment needs to be made towards long term health and stability of the affected area. By long term health and stability, I mean as close as one can get to the remainder of the life of our patient. This is our vision and goal. With proper continued care and maintenance, this can and will be achieved.

The radiograph of the above situation shows a darkening around the tip of the root, demonstrating an active infection that further compromised the long term health of the tooth. What I recommended and performed on this particular patient was to have the tooth removed in a very gentle manner in order to preserve the periphery of the affected area as best as possible. this was achieved successfully as the following photos will show. Of vital importance to this approach is gentleness!

This is the temporary that was made immediately after the patient presented originally with a broken tooth. Immediate steps needed to be taken in order to have our patient smile comfortably, without ever being concerned about a gap in the smile. This temporary restoration was bonded to the remnants of the root. Although it appears stable, it will not predictably serve the patient long term. This was done prior to the surgical phase.



The following images will present the results immediately after the surgery was performed. Despite the very common fears that the public may have about any dental surgery, as the result below clearly demonstrates, our approach is quite gentle in nature. It allows the patients own cells under proper guidance and monitoring to heal the treated area in way to resemble nature as closely a possible.

Here are the post surgical photos:



This is the provisional crown placed immediately after the implant was surgically placed. This was done on the same day, so the patient did not have to be concerned about having a removable prosthesis. Therefore, there is not even a concern of ever showing a gap within the smile. The radiographic image shows how the implant is completely surrounded by healthy bone, which is a vital element in the long term success of the procedure.

Donor tissue versus own tissue for root coverage

In this photo, there are multiple areas of root recession caused by excessive pressure form the tooth brush. Here our patient opted to use her own tissue taken from her palate to be used for the regeneration of the lost gingiva. This approach is considered by many practitioners to be the most predictable way to restore health.












This is the post operative photo of the above patient approximately 6 weeks after the procedure. The regenerated gingival (gum) tissue has added significant coverage to the previously denuded areas. The patient also stated that there is a noticable decrease in the amount of sensitivity to cold stimuli around the previously denuded areas.

Gum Recession! Is root coverage necessary?

Before & After views of root coverage procedure using donor tissue.

There are multiple reasons for receding gums. Tooth brush abrasion is a very common culprit. Our obligation as dentists is to first and foremost educate our patients to avoid putting excessive pressure on their tooth brushes. Also the amount of tooth paste used has a significant influence. Tooth pastes at large contain abrasive materials that in conjunction with too much force not only remove plaque, but also remove healthy underlying tissue. The result is denuded root surface as shown in the above photo. This tooth was previously restored with composite (tooth colored restoration) for good cause of covering the denuded surface. However, nature tells us that the best coverage for the teeth is healthy gingiva (gum tissue).

The same root surface has been treated by donor tissue in our facility with a special plastic surgery like approach in order to strengthen the underlying structure as well as gaining significant root coverage. The photo comparison clearly reveals the benefits from this treatment.