New Understandings and Protocols for Immediate Loading on Post-extraction Immediate Implant Placement

The goal of the present article is to describe the current advances and challenges in the clinical use of immediate implant placement protocols. The surgical management of the post-extraction socket at the time of tooth extraction includes the debridement of the socket and stabilization of the blood clot, bone grafting for alveolar ridge preservation or immediate implant placement. Immediate implant placement at the time of tooth extraction is a well-established primary treatment modality when adequate primary implant stability can be obtained in areas of an intact alveolus without buccal bone loss or soft tissue deficiency. Ideally, a bone-to-implant gap bigger than 2 mm should be present after ideal implant placement and this gap must be grafted with adequate bone substitute materials. Contemporary developments in digital diagnostic and planning tools, hard and soft tissue grafting, implant design and prosthetic approach have resulted in improved clinical outcomes, however, adequate case selection and surgical-restorative coordination are mandatory for optimal results.