Delayed Versus Staged Implant Placement
A Case Report
Perry A. Klokkevold, DDS
As a result of reviewing this case study, the reader should:
- Understand the processes of both delayed and staged implant placement
- Know when it is appropriate to use either of the afore mentioned techniques
Edentulous areas become visually unappealing when dentoalveolar bone resorbs and gingival contour collapses following tooth loss. The degree of resorption and gingival collapse depends on the quantity and quality of existing bone plus stresses on the alveolar ridge caused by prosthetic treatment and chewing.
The objective of implant placement is to facilitate aesthetically pleasing restorations. Implants must be placed in "prosthetically driven" positions to satisfy patients' aesthetic expectations. As a result, surgical procedures for the preparation and placement of dental implants have become more complex. If sufficient bone does not exist in the dentoalveolar ridge for optimal implant positioning, bone augmentation procedures are used to develop, or regenerate, the region.
Advanced procedures such as guided bone regeneration (GBR) and bone grafting to increase the bone volume have enabled the placement of implants into prosthetically driven positions. Depending on the quantity, quality, and support of existing bone as well as the preferences of the clinician and patient, the placement of implants following tooth extraction can be immediate, delayed, or staged. By definition, immediate implant placement occurs at the time of extraction. Delayed implant placement is performed approximately two months postextraction to allow for soft tissue healing and closure of the extraction site. Staged implant placement allows for substantial bone healing within the extraction site and typically requires a period of six months or more.
*Private Practice, Los Angeles, California
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