According to the 2008 Consensus Conference was held in Germany, the time after tooth extraction implant is divided into 4 categories:

– Category 1: simultaneous implant extractions

– Category 2: Early implant placement, usually after tooth extraction 4 weeks to 8 weeks

– Type 3: Early implant placement bone healing after 1 portion, usually 12 weeks to 16 weeks

– Type 4: Late implant placement after tooth extraction 6 months

Each type has pros and cons specified separately.


The implant is implanted simultaneously with tooth extraction shortens treatment time and achieve higher aesthetic if specified the correct case. However the disadvantage of treating type 1 is likely to cause the outer gum recession.
extraction of teeth implants after implants after tooth extraction
Implant achieve higher aesthetic outer gum recession (20 year of Guided bone regeneration? Buser 2010)

According to Doctor, Doctor Vo Van Nhan: the causes of gum recession outer surface as:

– Placement of the implant wrong, too deep on the inside, or put out

– Due to the implant immediately after tooth extraction should not need to open the gum (flip flap) should Surgeons difficult to determine the outer bone or lacking enough.

– Pushed hard palate bone implants out

– Patients with thin gum tissue

– Loss of soft tissue healing by sinking

– Do doctors lack the skills and expertise

However shorten the duration of treatment, but the case meet clinical conditions ideal to reach higher when applied NY thẩn Type I:

– The external skeleton intact and thick

– Type of thick gum tissue

– There is no infection in the dental implant

– Sugar low laugh: when patients laugh gums expose not see much

– The patient has no risk factors, such as not smoking, not drinking alcohol, …

Clinical application of Type I:

25-year-old male patient teeth broken by accident like to have back teeth by means of implants. Through the initial inspection, we found that the exoskeleton is still intact, but to define more clearly, we conducted test shooting movies.
3-dimensional CT scans 1 incisors broken by accident

From the information gathered through physical examination and x-ray film directly on the mouth, we find that this case has the elements suitable for Class 1, implant immediately after tooth extraction.
extraction of teeth implants after implants after tooth extraction
Extractions Implants implant immediately after tooth extraction

Do put blind (not flip flap) should in and immediately after implant placement, we conducted test shooting movies implant direction.
implant after implant roasted grape vine roasted
Film shooting 3D CT scans to check the direction taken Panorex implant after implant

According to Doctor, Doctor Vo Van Nhan: Because implant position is the cosmetic teeth (incisors) should after implant, the temporary teeth are attached to the patient is not empty tooth. However, temporary teeth will not touch the lower teeth fit.
implant after implant roasted grape vine roasted
Attach the following temporary teeth temporary tooth implant does not touch joints

After 3 months, the temporary teeth are replaced with porcelain dental implant, the end of treatment.
implant after implant roasted grape vine roasted
Porcelain dental implant x-ray Screening test porcelain teeth
implant after implant roasted grape vine roasted
Before treatment After treatment


The main advantages of early implant placement after tooth extraction from 4 weeks to 8 weeks is:

– Increase size from 3mm horn – 5mm, making sewing up the wound easily, so the risk of infection type of acute or chronic.

– According Buser D 2008, 2009, type 2 less gum recession than type 1.

Because of these advantages, but type 2 is widely specified for aesthetic dental areas as the front teeth.

However, the healing time from 4 weeks to 8 weeks, bone is a little pepper on the outside, width and alveolar bone crest unchanged.

Clinical application of type 2

This patient had an accident, broken front teeth and soft tissue lesions upper lip and chin area. After examining the wound condition, we decided to carry out implant treatment after 8 weeks injured patients.
implant after implant roasted grape vine roasted
The wound healed after 8 weeks of soft tissue wounds in the upper lip and chin

Then implant surgery took place quickly and temporary dental patients after surgery a few days. However, this is only temporary teeth so the teeth do not touch the lower teeth fit. This temporary teeth will be replaced with fixed restorations after 4 months.
implant after implant roasted grape vine roasted
Set screws implant healing after implant
implant after implant roasted grape vine roasted
Attach temporary teeth temporary teeth do not touch ceramic joints

4 months later, the gum was completely and implant healing time needed to achieve results as expected osseointegration. This is an appropriate time for final restorations on implant.
implant after implant roasted grape vine roasted
Healing gums after 4 months Gai reconstruct gums are also attaching temporary teeth after 4 months
implant after implant roasted grape vine roasted
Before After


After extractions 12 weeks to 16 weeks of bone healing in part to increase the stability of the implant in the future, but just a little bone graft or in some cases without bone graft healing time should be shortened and expenditures Free treatment is also reduced. Therefore implant according to category 3 is indicated for the aesthetic as incisor teeth. However, this technique is also applicable for the following positions lower teeth extractions if bone crest width than 8mm.
Although bone healing bone part but intact, extensive alveolar should achieve initial stability of the implant and a challenge for the treating physician.

Clinical application of category 3

Treating physician: Dr., Dr. Vo Van Nhan

40-year-old female patient, tooth loss due to an infection in the lower jaw. After extractions and treatment of infections, we decided 4 months after tooth extraction will conduct implant.
roasted grapes implant
Tooth infection is evident in movies Panorex

Through Panorex film, we determined right tooth infection, bone targets appear as loose teeth should first solution is the extraction of teeth, scraped clean to prevent bone infection was exacerbated consumption make it difficult for the restorative later.
roasted grapes implant
Wound healing after tooth extraction sockets 4 months tooth bone

4 months after tooth extraction, periodontal and alveolar bone was healing part. This is one of the factors that helped increase initial stability of the implant. In this case, though the bone was healing part but alveolar width greater still in the process of our implant artificial bone graft done.
implant after implant roasted grape vine roasted
Bone grafting implant artificial

Membranes used criteria for fixing material for transplantation and absorbable membrane will not need surgery again to remove the membrane.
implant after implant roasted grape vine roasted
Using the criteria fixed membrane graft material stitch the wound closed

Immediately after the implant, we take x ray to check the implant position and orientation plug to ensure a high success results.
roasted grapes implant
On the x ray film, we easily determine the location and direction of the implant as well as can be observed bone graft material

4 months after implant, bone development and integrates well with the implant. This is the right time to make the prosthesis on the implant. This phase softer surgery to expose the implant, in preparation for the final restorations.
roasted grapes implant

roasted grapes implant
good implant osseointegration reveal prepare for prosthetic implants

At this stage, we will perform a technique is equally important to help regenerate gum to achieve maximum treatment results, it is the engineering of gum aesthetics. However, this technique is very compact, largely based on the doctor’s technique.
implant after implant roasted grape vine roasted
Technical renewable renewable gum gum results
implant after implant roasted grape vine roasted
Before treatment After treatment

Immediately after attaching the prosthesis on the implant, we proceed to determine Panorex film shoot tight degree of porcelain teeth and implants because this job can not be identified with the naked eye. The close fit helps restore chewing function and prevent inflammation due to not fitting closely implant created.
roasted grapes implant
Check the close fit of the implant and porcelain teeth on films Panorex


6 months after tooth extraction, bone healing is purely to facilitate implant treatment for patients, especially those patients aged 18 to 20 years old. This case also applies to patients who can not implant soon after tooth extraction because of personal reasons.

However, the main disadvantage of waiting until healing after 6 months or longer is reduced bone crest width less than 6mm. This risk is higher in the upper front teeth and molars small. Therefore, if the implant after tooth extraction for 6 months or more may have a bone graft. Also, having to wait too long to do this treatment process is not the preferred choice of patients.

Clinical application of category 4

Treating physician: Dr., Dr. Vo Van Nhan

Female patients wearing removable dentures for more than 5 years due to loss of front teeth in an accident. Over the past 5 years, many times patients are embarrassed to loose dentures while working with clients and colleagues, the patient came to us with the desire to get dentures fixed to be more confident in communication and improve chewing function.
implant after implant roasted grape vine roasted
Condition before treatment: shrunken gums
alveolar bone healing but in spite

due to prolonged loss of tooth loss gums spikes
initially diagnosed as bone transplants

After taking steps examinations and diagnostic CT images on 3D movies as well as oral hygiene practices and certain preoperative tests to assess the overall health of the patient, we conducted surgery implant with bone graft and implant.
implant after implant roasted grape vine roasted
Implant autologous bone transplantation and artificial bone

The process of implant and bone graft took place about half an hour with the help of a cardiologist monitoring the patient’s blood pressure but this is not too complicated cases. During implant, the film x-ray taken to check the direction and location always pay attention because we do not allow any negligence. To complete the surgery, we use absorbable membrane to immobilize graft materials and finally sewing up wounds.
implant after implant roasted grape vine roasted
Put absorbable membrane graft material fixed stitch the wound closed

Pending the final restorations on implant, patients can use the old removable dentures, or using the new temporary teeth by our lab offers.

After the time required to implant osseointegration (in this case is 3 months), the implant was exposed to the final prosthesis. This stage takes place gently and quickly. While revealing the implant, we implement techniques to help create natural hemp as it was gum tooth loss.
implant after implant roasted grape vine roasted
Coi gum implant technique disclosed gum helps create natural hemp

In this case, patients also want to do it again next porcelain teeth missing teeth with porcelain material (all ceramic). This type of cosmetic porcelain dental today because no black gum line real-time, high biological compatibility so well suited to the aesthetic areas like incisor teeth.

Before attaching porcelain restorations to implant, work stations are made very carefully with the assistance of x-ray film because then we affirm slopes close fit.
implant after implant roasted grape vine roasted
Try slopes full ceramic porcelain teeth
implant after implant roasted grape vine roasted
Before treatment After treatment
(This is the clinical cases were treated Ts.Bs.Vo Van Nhan, all matters questions, please contact the Office of Human Bs.Vo. So colleagues suggest you please do not use or copy copy in any form)