Immediate dental implant placement and cantilever bridge
What is immediate dental implant placement? Immediate implant placement is when an implant is placed at the same time as the natural tooth is extracted. It was first reported in 1976. It has similar high success rate as traditional delayed implant placement. The main benefits of immediate implant placement are reduced treatment time and number of visits. If immediate loading is possible, tooth extraction, implant and temporary crown can be completed on the same day (same day tooth).
In this case, a cantilever bridge broke off from a natural tooth abutment. The tooth fractured right to the gum line. The patient didn't want a denture. Apart from implant supported cantilever bridge, another fixed prosthetic option was selective root canal treatment, post and core, surgical crown lengthening and a new 3 unit bridge. However the long term prognosis of the broken tooth was uncertain because too much tooth structure had been lost. Two implants could be the best option but it would cost much more and the lateral incisor would need soft tissue grafting to achieve the best aesthetic result. The patient was happy with his old cantilever bridge and wanted to have a new one with implant support.
After discussing the advantages, disadvantage and cost of each option, the patient decided to replace with an implant supported cantilever bridge.
Immediate dental implant placement was planned but not immediate loading. The main concern was the stress on provisional crown because the patient has bruxism and deep bite, also it was a cantilever bridge, not a single crown.
The final result was satisfactory functionally and aesthetically.