Immediate Implant Placement and Provisionalization (IIPP)

Implant placement in the extraction socket and immediate provisionalization meets patient expectations for short treatment time.

Immediate Implant Placement and Provisionalization (IIPP) is an approach that leverages high initial implant stability in extraction sockets (even in compromised sites) and immediate temporization to provide patients with a tooth on the first appointment. "Come in with a tooth, leave with a tooth"

Expert insights

Every day patients present with teeth that are non-restorable: fracture, endodontic failures, advanced caries and periodontally hopeless. Immediate implant placement and function represents a predictable, definitive and reliable solution leading to high levels of patient satisfaction. This lecture focuses on key factors related to immediate implant placement and function in single-tooth & multiple-tooth cases. Long-term functional and esthetic results, as well supporting data are presented.
Dr Staas emphasizes the importance of positioning the implant in the palatal wall of the extraction socket and a sufficient thickness of the buccal bone of at least 2 mm. Immediate implant placement has an advantage as any additional treatment activity has a potential risk for failure, complications or tissue compromise.
36:38 - end. Immediate implants with simultaneous regenerative procedures optimize site anatomy, heighten esthetic outcome, accelerate the treatment sequence, preserves site dimensions, optimum timing for bone and gingival tissue regenerative procedures, platform for esthetic tooth replacement and socket seal, high patient satisfaction, minimizes number of surgical procedures. high predictability, compares favorably with intact sites, steady state of regenerated bone under loading.
Immediate implants and immediate provisionalization (IIPP) has been shown to provide optimal preservation of soft and hard tissues. Often IIPP is reserved for carefully selected cases with minimal risks, however, early evidence has suggested similar survival rates for implants placed in compromised sites. This presentation illustrates how IIPP can benefit advanced periodontitis sites in the esthetic zone. This technique reduces the number of surgeries on patients with minimal trauma after extraction. It also demonstrates the possibility of stable long-term preservation of soft and hard tissues.
Immediate implant placement allows for a reduced number of surgical visits, less time to final restorations, decreased cost for patients, high implant survival rates and bone maintenance. These treatment protocols can be successfully applied to both foundational and advanced cases, including those with socket infection and limited bone availability. This demonstrates the efficacy of immediate implant placement, supported with long term follow-up studies and comparison of intact site and immediate implant placement data bases.
Supported by a patient case, the lecture discusses how to stabilize the tissues and avoid tissue recessions. Dr Kan reviews the three mains considerations, gap size, socket size and implant diameter. To compensate for the facial ridge remodeling and achieve a proper prosthetic emergence, a combination of grafting the gap and facial graft shows the most promising results in comparison to no graft or grafting the gap only

Digital Textbooks

Single Implants and their Restoration
Single implants and their restoration
Over the past 20 years there have been significant changes from the original Brånemark implant treatment protocols. Perhaps foremost has been immediate implant placement at the time of extraction which has become a viable treatment method. In addition, barrier membranes and grafting materials have been successfully used in conjunction with the immediate placement to augment extraction sockets and bony defects adjacent to immediately-placed implants.
Single Implants and their Restoration
Single implants and their restoration
Preservation of the peri-implant hard and soft tissues is an important aspect of the final esthetic result achieved with a single implant and its crown. Therefore, it is important to understand the biologic environment and the many factors that can enhance or detract from preservation when an implant is immediately placed into an extraction socket and a provisional crown attached to the implant.