Immediate implant placement vs. delayed

Immediate placement is defined as implant placement in conjunction with tooth extraction and offers several benefits for the patient and the clinician. It reduces the treatment time with several months since implant osseointegration coincide with soft tissue healing after extraction. Today immediate implantation combined with immediate provisionalisation further enhances socket and soft tissue preservation, cost-benefits and patient comfort. The first-generation dental implants resulted in unacceptably high failure rates. The introduction of rougher surfaces, however, has improved survival in such a way that comparable results to implants placed in a delayed manner have been obtained. A brief overview of evidence-based literature will be given pointing to the prerequisites needed for an optimal clinical implant survival. On the other hand, implant placement in the aesthetic zone is more critical and more demanding. It is imperative that after implant placement the hard and soft tissues are in perfect harmony with the neighbouring natural teeth. The process of healing and tissue preservation seems to benefit from immediate provisionalisation but is affected by the patient’s biotype. The clinical results of a prospective clinical trial will be presented whereby single implants were placed in the anterior maxilla in either healed bone or in extraction sockets. The discussion will focus on bone and soft tissue healing and patient-centered aesthetic outcome. Clinical guidelines for this treatment option will be given regarding the surgical as well as prosthetic approach in order to obtain predictability