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Immediate Extraction and Implantation: The Single-Tooth Solution for Anterior Esthetics

Immediate Extraction and Implantation - Dental CE Course
Launch Course

Course Objectives (1 CE Credit)

Paresh B. Patel, DDS

The traditional approach to single-tooth replacement has involved leaving the extraction site to heal prior to implantation and allowing the implant to fully osseointegrate prior to loading. Even clinicians who have opted for immediate implant placement have often been hesitant to load the implant before the healing phase is complete. However, with a better understanding of the benefits of immediate implantation and provisionalization, including preservation of the hard and soft tissue that are so fundamental to an esthetic outcome, there is substantial incentive to follow a more progressive protocol when indicated. Topics include:

  • The benefits of placing the implant immediately following tooth extraction
  • The advantages of provisionalization
  • Achieving highly esthetic results in the anterior
  • Methods for preserving the hard and soft tissue of the implant site
  • Innovations that have made anterior tooth replacement simpler and more predictable
  • Techniques for achieving maximum primary stability and a natural emergence profile
  • Favorable implant design characteristics for immediate implantation procedures
  • Establishing proper labial-lingual positioning


Immediate extraction and implantation provides a predictable means of tooth replacement in the esthetic zone. This approach to implant treatment reduces the total number of appointments needed to replace a tooth, an advantage that benefits both the clinician and the patient. In combination with provisionalization, which supports the contours of the gingiva in preparation for the final crown, immediate implantation helps establish the foundation needed for an esthetic outcome.

CAUTION: When viewing the techniques, procedures, theories and materials that are presented, you must make your own decisions about specific treatment for patients and exercise personal professional judgment regarding the need for further clinical testing or education and your own clinical expertise before trying to implement new procedures.


  1. Noelken R, Neffe BA, Kunkel M, Wagner W. Maintenance of marginal bone support and soft tissue esthetics at immediately provisionalized OsseoSpeed implants placed into extraction sites: 2-year results. Clin Oral Implants Res. 2014 Feb;25(2):214-20.
  2. Guarnieri R, Ceccherini A, Grande M. Single-tooth replacement in the anterior maxilla by means of immediate implantation and early loading: clinical and aesthetic results at 5 years. Clin Implant Dent Relat Res. 2015 Apr;17(2):314-26.
  3. Qi Y, Zhang J, Hasi BG, Sun Y, Zhu ZH, Wang RJ. [Clinical study of healing abutment on sealing socket and preservation of the gingival natural profile in single-tooth immediate implantation]. Zhonghua Kou Qiang Yi Xue Za Zhi. 2008 May;43(5):299-301.
  4. Khzam N, Mattheos N, Roberts D, Bruce WL, Ivanovski S. Immediate placement and restoration of dental implants in the esthetic region: clinical case series. J Esthet Restor Dent. 2014 Sep-Oct;26(5):332-44.
  5. Block MS, Mercante DE, Lirette D, Mohamed W, Ryser M, Castellon P. Prospective evaluation of immediate and delayed provisional single tooth restorations. J Oral Maxillofac Surg. 2009 Nov;67(11 Suppl):89-107.
  6. Covani U, Cornelini R, Calvo JL, Tonelli P, Barone A. Bone remodeling around implants placed in fresh extraction sockets. Int J Periodontics Restorative Dent. 2010 Dec;30(6):601-7.
  7. Tealdo T, Bevilacqua M, Menini M, Pera F, Ravera G, Drago C, Pera P. Immediate versus delayed loading of dental implants in edentulous maxillae: a 36-month prospective study. Int J Prosthodont. 2011 Jul-Aug;24(4):294-302.
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