Fixed teeth in a day

The term describes two steps that can be combined.

With immediate implant placement, the implant is inserted into the tooth socket straight after the tooth has been removed – exactly where the root used to be. Extraction and implant placement take place in a single session.

With immediate restoration, the implant receives a fixed temporary crown – or, if several implants are placed, a fixed temporary bridge – on the same day. It is made by our dental laboratory partners and closes the gap until the final restoration follows after the healing phase.

Immediate implant placement does not automatically mean that a fixed crown is possible on the same day. Whether both can be combined depends on the findings – and is only finally decided during the procedure.

In most cases, it is not about the whole jaw but about a single tooth that can no longer be saved – after an accident, a root fracture or deep decay, for example. The tooth is removed gently, the implant is placed directly into the socket and, if it is stable enough, fitted with a fixed temporary crown on the same day. The neighbouring teeth remain untouched – unlike with a bridge, for which they would have to be ground down.

This approach can be suitable for front teeth and premolars (the small back teeth). For molars (the large back teeth), immediate implant placement is usually not possible because the socket is considerably larger than the implant. Here, the bone is allowed to heal first before the implant is placed.

If several adjacent teeth are missing, two implants can be placed and fitted with a small fixed bridge – again on the same day, if the conditions are suitable.

If a jaw has no teeth left, or the remaining teeth are no longer worth saving, it can be restored with several implants – at least four, usually four to six per jaw. If the implants are sufficiently stable, they often receive a fixed temporary bridge on the same day. This treatment concept is widely known as All-on-4.

It may be an option for:

• —patients with a completely toothless jaw
• —patients whose remaining teeth are severely damaged and no longer worth saving
• —denture wearers who would like a fixed solution

1. Examination and planning. Treatment begins with an examination and diagnostics. The procedure is planned digitally in three dimensions, based on a 3D X-ray (CBCT) scan.

2. Gentle tooth removal. We remove the tooth that cannot be saved – or the remaining teeth – in a way that preserves as much bone and gum as possible.

3. Placing the implants. Directly afterwards, the implant is inserted into the socket; for a full jaw, several implants are placed.

If you wish, the procedure can be carried out under sedation – see “I’m anxious about treatment” for more.

4. Fixed temporary on the same day. If the implants sit firmly enough in the bone (primary stability), they are fitted with a fixed temporary crown or bridge on the same day. It is shaped so that it takes as little load as possible when you chew.

5. Final restoration. After a healing phase of several months, the permanent crown or bridge is made and fitted.

What you receive on the day of treatment is a fixed temporary: it sits firmly on the implant and closes the gap, but it is not the final restoration. It bridges the healing phase while the implant fuses with the bone.

During this time, the implant must not be put under too much strain. You will receive specific advice on diet, care and how to protect the treated area. Only then is the permanent crown or bridge made and fitted, replacing the temporary.

Whether an implant is firm enough on the day of treatment can only be judged conclusively during the procedure. If stability is insufficient, the implant first heals without any load. During this time, the gap is closed with a small removable denture or a clip-on temporary – a temporary that clips onto the neighbouring teeth. We discuss this alternative with you beforehand. Long-term stability and a good aesthetic result take priority over speed.

Requirements for treatment include sufficient bone, healthy gums and no acute inflammation. Your general health and personal risk factors are also taken into account in the planning.

If bone is missing, it can be built up. Grafting to add width can often be done during the same procedure. Grafting to add height is sometimes more involved and may then require a separate procedure before the implant can be placed. The preliminary examination shows whether you need a bone graft, and which kind.