Is an immediate implant safe if there is infection?

Immediate implants are not advised if infection is uncontrolled. If the site is thoroughly cleaned and primary stability can be achieved, some cases may proceed, but many are better delayed depending on imaging and tissue health.

What increases recession risk with immediate implants?

Thin tissue, minimal facial bone, socket defects, or incorrect implant angulation increase recession risk. Tissue or bone grafting and precise 3D placement help reduce this risk.

How do immediate, early, and late implant placements differ?

Immediate placement is done the same day as extraction. Early placement is after 4 to 16 weeks. Late placement is after 6 months or more. The choice depends on infection control, bone quality, and implant stability.

Do immediate implants fail more often?

Both approaches have high success rates. Research shows a small increase in failure risk with immediate placement, but correct case selection reduces this risk.

Will I always need grafting with an immediate implant?

Not always. Many immediate implant cases require grafting to maintain bone support and achieve good esthetic results.

If I wait, how can I protect future implant options?

Alveolar ridge preservation at extraction helps maintain bone width and reduces the need for larger grafts later.

Can I get a temporary tooth right away?

A temporary tooth can be placed immediately only if stability and bite conditions allow. Otherwise, a non-loaded temporary or removable option is used during healing.

Does teeth grinding change the implant plan?

Yes. Grinding increases stress on implants. Your dentist may delay loading and recommend a night guard to protect the implant during healing.

Immediate Tooth Implant After Extraction: When Is It Safe?

Smile Stories Digital
Nov 22
2 min read

Pulled tooth today implant tomorrow? In some cases, yes. Immediate implants can shorten treatment time and preserve bone, but only when biology and stability line up. This guide decodes when immediate placement is truly safe, when to wait a few weeks, and how your gum/bone profile, infection control, and bite forces shape the decision. We also map realistic timelines, risks, and long-term outcomes—so you choose a plan that heals fast, looks natural, and lasts.

Timing Options

Immediate placement (Type 1): implant placed the same day as extraction.
Early placement: after soft-tissue healing (≈4–8 weeks) or partial bone healing (≈12–16 weeks).
Late placement: after full bone healing (≥6 months).

When Immediate Implants Are Generally Safe

Primary stability achievable at surgery (adequate bone to anchor the implant in ideal 3D position).
Healthy or repairable socket walls (especially facial/buccal bone) and a favourable tissue biotype—or a plan for simultaneous grafting.
Infection controlled (no uncontrolled acute infection; debrided site with clean margins).
Restorative pathway is feasible (final crown position/angulation won’t compromise bone or gums).
Patient factors support healing (good oral hygiene; smoking controlled; systemic conditions medically managed).

When You Should Delay

Thin or missing facial bone, major dehiscence, or socket defects that prevent stable implant positioning.
Active, uncontrolled infection you can’t fully clean at surgery.
Cannot achieve primary stability (poor bone volume/density at the right angle).
Unfavourable soft-tissue baseline (recession, inadequate keratinized tissue) without a clear augmentation plan.
Systemic/behavioral risks: heavy smoking, poorly controlled diabetes, parafunction without protection.

What the Evidence Says

Survival: Well-selected immediate implants show high survival comparable to healed-site implants, though literature notes a slightly higher failure risk (~3% absolute) in immediate protocols.
Esthetics: Immediate placement carries a higher risk of mucosal recession, especially with thin tissue/bone or if the implant is malpositioned. Careful 3D positioning and augmentation mitigate this.
Bone preservation: If you defer implants, alveolar ridge preservation (ARP) after extraction helps limit ridge shrinkage and can simplify future implant placement.

Timeline

Immediate placement path: extraction → thorough debridement → implant placement (often with bone/soft-tissue grafting) → healing abutment or temporary (load only if stability/occlusion allow) → final crown after integration.
Early/delayed path: extraction → ARP (if needed) → healing 4–16+ weeks → implant placement → osseointegration → final crown.

Chairside Decision Map

Can we seat the implant in ideal 3D position with firm primary stability?
Are facial/buccal socket walls intact or correctable with grafting?
Is infection fully controlled at the site?
Will soft tissue support a stable, esthetic margin—or do we augment now?
Do your habits/health support healing (hygiene, smoking control, bruxism guard)?

If all five = Yes → Immediate is often reasonable. If not, early/delayed placement tends to yield better, more predictable aesthetics and longevity.

Pain, Comfort & Downtime

Local anesthesia means you’ll feel pressure, not pain. Expect 2–5 days of soreness/swelling after extraction/implant, soft diet, and careful hygiene. If a temporary is used, your bite may be adjusted to protect the site while it integrates. (Your clinician will define activity and diet limits based on stability.)

Cost & Long-Term Thinking

Immediate placement can reduce total visits and help preserve tissue contours, but do not rush if stability or esthetics are compromised; those shortcuts cost more later. Patients who delay should ask about ARP to maintain future options. Cochrane Library

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