Timing of implant placement relative to tooth extraction

In recent years, immediate or early implant placement after tooth extraction has becoming more common. The present review focuses on the clinical outcome of immediate or early implant placement. Only limited knowledge exists about most of the factors with particular significance for this treatment mode. Randomized controlled clinical studies comparing the various treatment protocols are scarce. With the background in the existing literature some conclusions can be drawn with caution. Survival rates for implants placed immediately, early, delayed, or late seem to be similar in the short perspective and amounts to approximately 95%. Successful immediate implant placement may be possible in all regions of the jaws, although replacement of molars is more challenging. Chronic infection is not an absolute contraindication for immediate implant placement. It is controversial whether immediate placement of implants may preserve the alveolar bone. Small gaps between implant surface and socket wall have a potential for spontaneous healing. No consensus exists on the need for bone augmentation in these situations. With the limited information available it may be stated that a good prognosis can be obtained following immediate/early functional or non-functional loading of immediately placed implants. However, higher risk of failures seems to exist compared with a delayed, conventional approach. It is advocated that this treatment modality should be restricted to skilled well-trained teams. Data on the aesthetic outcomes following immediate/early implant placement are inconclusive, but this treatment can offer high patient satisfaction with the aesthetic and functional outcomes.