Immediate vs. Conventional Dental Implants: Definitive Guide & FAQ
Dental implants are the gold‑standard solution for missing teeth, yet placement protocols differ. Two main approaches exist:
| Approach | When is the implant placed? | When is the final crown delivered? | Main goal |
| Immediate | Same day as extraction (or within 24 h) | 6–12 weeks later (early load) or even 48–72 h (immediate load) | Preserve bone/gingiva, cut visits, maintain aesthetics |
| Conventional (delayed) | 6–12 weeks after extraction, once the socket heals | 3–6 months after proven osseointegration | Assure strong bone integration & manage risks |
Below you’ll find a comprehensive analysis that answers the most common patient and clinician questions.
1. What exactly is an immediate implant?
The damaged tooth is removed, socket integrity confirmed, a titanium screw inserted, and a provisional abutment fitted in the same session.
- Key perk: bone keeps its mechanical stimulus, so alveolar loss is minimal.
- Requirement: vestibular bone wall ≥ 2 mm and no active severe infection.
2. What counts as a conventional implant?
First the tooth is extracted and the socket left to heal; weeks later the implant is placed. The final crown is fitted once radiographic osseointegration is confirmed.
- Key perk: lower risk of micromovements compromising integration.
- Ideal for: thin/defective bone, heavy smokers, active periodontal disease.
3. Benefit comparison
| Category | Immediate | Conventional |
| Initial aesthetics | Papilla & soft tissue preserved; no gap in smile | May need a removable temp denture |
| Surgeries required | 1 (extraction + implant) | 2 (extraction, then implant) |
| Total treatment time | 2–4 months | 4–8 months |
| Crestal bone loss | Lower if technique/stability optimal | Slightly higher due to post‑extraction remodeling |
| 5‑year success | 94–97 % | 95–98 % |
| Technique sensitivity | High: needs ≥ 35 N cm primary stability | Moderate: 20–30 N cm acceptable |
| Cost | Similar or 5–10 % higher (provisional parts) | Slightly lower |
4. Patient FAQ (short answers)
| Question | Answer |
| Does an immediate implant hurt more? | No; postoperative discomfort is similar and managed with analgesics. |
| Is waiting safer? | Yes, for chronic infection, heavy smoking, or insufficient bone. |
| Can I chew right away? | With immediate load: soft foods only, limited function 6–8 weeks. |
| What if an immediate implant fails? | It’s removed, bone grafted, and a delayed protocol used after 3–4 months. |
| I’m a controlled diabetic— which is better? | Both work if HbA1c < 7 %. Choose delayed if healing is slow. |
| Approx. cost in Latin America? | USD 900–1 500 (immediate) vs. USD 800–1 400 (conventional). |
5. Clinician FAQ (evidence summary)
| Clinical point | Evidence |
| Optimal insertion torque | 35–45 N cm for immediate load; ≥ 20 N cm for delayed. |
| Survival in the esthetic zone | Meta‑analysis: 96 % immediate vs. 97 % delayed at 3 yrs (ns). |
| Common complications | Immediate: ≤ 1 mm gingival recession, thread exposure. Delayed: ridge collapse, graft need. |
| Simultaneous GBR | Advised in both if buccal gap > 2 mm (particulate graft + resorbable membrane). |
| Gingival biotype | Thin biotype → higher recession risk; consider careful provisionalization or delayed protocol. |
6. So… which one is “better”?
| If you have… | Recommended |
| Thick bone, healthy gums, good hygiene, high esthetic demand | Immediate implant |
| Apical infection, thin biotype, bone loss, smoking > 10 cigs/day | Conventional implant |
| Full‑arch need | Consider All‑on‑4 immediate if torque > 35 N cm |
7. Key takeaways
- Similar success: mid‑ and long‑term survival rates are statistically alike.
- Speed vs. predictability: immediate wins on time & early aesthetics; conventional offers an extra safety margin.
- 3‑D assessment is vital: CBCT & digital planning decide if the socket suits immediate load.
- Surgeon experience matters: immediate protocol has a steeper learning curve.
8. Final patient tips
- Request a 3‑D scan before choosing.
- Ensure the clinic follows strict sterilization & digital torque control.
- Quit smoking during healing (minimum 8 weeks).
- Adhere strictly to diet & hygiene— 80 % of success lies in after‑care.
9. Step‑by‑Step for Each Protocol
| Phase | Immediate Implant | Conventional Implant |
| 1. Diagnosis | CBCT, digital models, selection of screw and provisional abutment. | Same: CBCT and models; plan socket preservation. |
| 2. Surgery | Local anesthesia → atraumatic extraction → gentle curettage → drilling and implant placement (3–4 mm apical to crestal bone) → healing abutment or screw‑retained provisional crown. | Atraumatic extraction → graft placement if needed → suturing and 6–12 weeks of healing. |
| 3. Healing | X‑ray check at 1 week; hygiene with 0.12 % chlorhexidine. | After 2 months, control CBCT; drilling and implant placement; healing cap. |
| 4. Final prosthesis | At 6–12 weeks (early load) or 48–72 h (immediate load) depending on torque. | At 3–6 months, once osseointegration is stable. |
| 5. Maintenance | Check‑ups at 3, 6 and 12 months; annual X‑rays; prophylaxis every 6 months. | Identical maintenance schedule. |
10. Implant Materials & Designs
- Grade‑4 titanium with SLA surface – promotes rapid osseointegration.
- Zirconia implants – high aesthetics for thin biotypes, lower bacterial adhesion.
- Tapered macro‑design – better primary stability in post‑extraction sockets.
- Aggressive self‑tapping thread – reach ≥ 35 N cm torque for immediate load.
- CAD/CAM provisional abutment shapes the gingiva and guides healing (key in immediate cases).
11. Detailed Costs (2025 reference, Colombia)
| Item | Immediate (USD) | Conventional (USD) |
| 3‑D diagnosis + intra‑oral scan | 120 | 120 |
| Titanium screw + provisional abutment | 680 | 650 |
| Membrane + graft (if buccal gap > 2 mm) | 150 | 150 |
| Surgery fee | 350 | 300 |
| Final e.max or zirconia crown | 450 | 450 |
| Approx. total | 1,750 | 1.670 |
Note: Dental‑tourism clinics often add 10–15 % for lodging and transfers.
12. Common Myths & Facts
| Myth | Fact |
| “Immediate implants always fail more.” | With proper case selection, survival is equivalent. |
| “You can’t place immediate implants in premolar sites.” | Yes, if buccal bone ≥ 2 mm and torque is adequate. |
| “A mild infection rules out the immediate protocol.” | Controlled infection (no active pus) allows immediate placement with antibiotics. |
| “Zirconia implants aren’t suitable for immediate load.” | Recent studies show comparable torque to titanium; macro‑design is the key factor. |
13. Clinical Case (Summary)
- Patient: 35‑year‑old, root fracture in maxillary central incisor.
- CBCT: 2.5 mm buccal bone, 14 mm height.
- Procedure: Atraumatic extraction, 3.5 × 13 mm tapered implant, 42 N cm torque, PMMA hybrid provisional.
- Outcome: Final crown at 10 weeks; crestal bone loss 0.3 mm after 1 year.
- Satisfaction: 10/10 aesthetics and comfort, no additional graft needed.
14. Long‑Term Maintenance
- Electric toothbrush with soft head + Superfloss around the abutment.
- Gentle water flosser to remove subgingival biofilm.
- Avoid bruxism without a night guard; control lateral forces.
- Semi‑annual reviews measuring pockets with a plastic probe.
15. Expanded Conclusion
The immediate‑vs‑conventional dilemma isn’t solved by a single “best” choice; it requires rigorous clinical assessment aligned with patient esthetic goals and timing expectations.
- Immediate implant: Ideal for those who value rapid aesthetics and have a favorable bone‑gingival environment.
- Conventional implant: Wise in compromised scenarios where biological predictability is the priority.
Consult a certified implantologist and demand personalized 3‑D digital planning—that’s where real success lies, beyond the chosen protocol.