Ridge Preservation: When do you place the Implant?

Sat, 02/28/2009 - 12:13 — hawkeye

I have been to many conferences and lectures. Obviously there seems to be a move toward extraction and grafting the socket vs immediate placement due to predictability. That being said, I heard various debate on when to actually place the implant.....Some say 4 weeks , some 8 weeks and even some wait 3-4 months. I would like to know what peoples protocols are for placing implants post socket grafting and their rationale. Thanks

Implantology

Thu, 08/05/2010 - 07:22 — Mental Foramen

OMG! Clear Choice WTF???

I just had a patient come into my office from a Clear Choice office. This patient wanted a second opinion on the $28,000 treatment plan they presented.

I don't even want to post anything more because I don't want Clear Choice suing me. All I can say is I will be shaking my head for the remainder of the day. OMG.

Thu, 08/05/2010 - 08:13 — LaurenJones

28,000 for what? Clear choice office by me.

I have a clear choice office by my office in VA. The ads they run are they do quality work at a cheap price.

What did they do?

Sun, 06/13/2010 - 09:46 — Misch Follower

Ridge Preservation: When do you place the Implant? 3 Months

I wait a minimum of 3 months, any early and the socket is soft.

Thu, 06/03/2010 - 12:37 — Oliver Queen DDS

Socket Preservation: Wait 2-3 months

I graft a socket with FDBA and calcium sulfate and come back 2-3 months later and get consistently hard bone.

Primary closure helps.

Wed, 06/02/2010 - 14:23 — Dr. Wentkel

Ridge Preservation: When to place the Implant?

I usually go back 3-4 months later post grafting. I usually find the graft is pretty consolidated.

I am looking to see what others are doing?

Fri, 02/26/2010 - 10:03 — SL Kang

Socket Preservation- Waith 3 Months

Wait at least 3 months post socket grafting to place your implant. I use freeze dried bone and calcium sulfate.

Fri, 01/08/2010 - 14:31 — Dean Spivey

Ridge Preservation: I place the implant...

For a straight foward site Ill wait 8-12 weeks. If there is a buccal defect I will wait 4 months.

I use either Puros or Bio-oss and a cytoplast non resorb membrane.

Mon, 11/23/2009 - 06:56 — Perioplasticsurgeon

Ridge Preservation: Lately I been waiting 3-4 months

I started waiting 3-4 months on placing my implants post socket graft and I notice that the bone is more solid.

Seems to be better turnover the graft material by waiting a few weeks more.

Sun, 10/25/2009 - 18:42 — Dr90210

Ridge Preservation: I usually what 3 months for Stage I

3 Months at the earliest. I may what longer if there is a buccal defect.

Tue, 10/20/2009 - 05:55 — DrTimberlake

3-4 months is when implant should be placed after graft

Best time to place implant is 3-4 months after graft. Otherwise it will be to soft.

Thu, 06/18/2009 - 11:06 — OrthoKing

Ridge preservation: I place the implant at>>>>>

I usually place the implant at 8 weeks
and but have been know to wait 4-5 months. It depends on the site assessment at the time of extraction. If the implant can be well stabilized in host bone then I will place it at 8 weeks. Otherwise if the site is compromised I tend to wait longer.

Tue, 05/26/2009 - 09:10 — Mental Foramen

6 weeks on average

If normal socket, 6 weeks. If wall blasted out, I wait a bit longer.

Mon, 03/02/2009 - 15:28 — Perioplasticsurgeon

Ridge Preservation I usually wait 8 weeks

I concure with Nicholas Shumaker. He is spot on but on average I go back 8 weeks later ala evian. I usually find the site hard enough to get implant stability.

Sat, 02/28/2009 - 21:04 — N Shumaker DDS MS

Implant placement timing in grafted sockets...it depends..

I generally place the implant at the earliest 8 weeks
and at the latest 4-5 months. For me it depends on the site assessment at the time of extraction/grafting. If the anticipated position/placement of the implant will end up mostly IN the socket itself (all in grafted bone), then I wait 4-5 months. If the implant can be well stabilized in host bone at least 50-75% of it's length then I will place earlier.

Go back and look at the classic Becker studies where they placed implants in GBR augmented bone at different intervals and then loaded the implants also at different intervals....if you disturb the site to early you will see more resorption of your graft at the time of loading. Just the same if you load too early you will see resorption of the graft as well. ALso don't forget the Evian studys on peak osteogenic activity in the socket at 8 weeks, so you want to wait at least that long.

You are never wrong to wait longer...up to 9 months. I understand the market and patient pressures to do it faster, but don't forget what is driving this...mostly $$$ and not necessarily sound clinical care based on evidence and wound healing principles.

Wed, 03/04/2009 - 21:59 — Richard Hughes DDS

Socket grafting and when to place implants.

I usually in the maxillary arch will graft and place the implant in the same setting, but if and only if the site is not infected or can be adequately degranulated and detoxified. As per the mandibular, I may graft and later place an implant , however if there is enough distance from the IAN, I will graft and place the implant at the same appt. and again if and only if as with the maxilla. I will usually give this a six month period to let the bone turn over. I have found that "Osteogen" is an excellent particulate graft material.