Immediate implants after extraction. A review of the current situation

Immediate implants are positioned in the course of surgical extraction of the tooth to be replaced. The percentage success of such procedures varies among authors from 92.7-98.0%. The main indication of immediate implantation is the replacement of teeth with pathologies not amenable to treatment. Its advantages with respect to delayed implantation include reduced post-extraction alveolar bone resorption, a shortening of the rehabilitation treatment time, and the avoidance of a second surgical intervention. The inconveniences in turn comprise a general requirement for membrane-guided bone regeneration techniques, with the associated risk of exposure and infection, and the need for mucogingival grafts to seal the socket space and/or cover the membranes. The surgical requirements for immediate implantation include extraction with the least trauma possible, preservation of the extraction socket walls and thorough alveolar curettage to eliminate all pathological material. Primary stability is an essential requirement, and is achieved with an implant exceeding the alveolar apex by 3-5 mm, or by placing an implant of greater diameter than the remnant alveolus. Esthetic emergence in the anterior zone is achieved by 1-3 mm sub-crest implantation. Regarding guided regeneration of the alveolar bone, the literature lacks consensus on the use of membranes and the type of filler material required. While primary wound closure is desirable, some authors do not consider it to be of great relevance.