Author: Tom James – National Sales & Marketing Manager
With over 16 years in the dental industry, Tom has worked with some of the world’s leading manufacturers in a variety of sales, marketing, and leadership roles. He brings extensive expertise in leveraging the latest technology and innovations to deliver first-class service and support to the dental profession.
Dental implants support the rehabilitation of tooth loss, providing a long-lasting and reliable replacement to the natural dentition. Each implant offers a functional and aesthetic restoration to rehabilitate, and often improve, a patient’s quality of life – whether being able to comfortably bite back into an apple or feeling more confident when smiling.
The placement of the implant is pivotal for treatment success. Alongside the physical location of the implant, clinicians must consider the timing of the treatment. The debate between immediate and delayed implant placement is one that must be considered with every patient, and is also something that the patient should be equally informed about due to the potential differences in survival rates and the influencing factors affecting them.
Breakthrough research
Post-extraction of the treated tooth, alveolar bone resorption poses a significant challenge for the maintenance and stability of an implant. On average, bone resorption ranges from 5-7mm horizontally and 1mm vertically within the first three months of the extraction.[i] Whilst autologous grafts and biomaterials can help preserve the alveolar ridge ready for a delayed implant placement, both clinicians and patients may favour the benefits of immediate placement. In particular, this protocol minimises surgical interventions, reduces treatment time and improves aesthetics for an initially more satisfying patient experience.[ii]
However, research has continually sought to define if immediate placement carries a higher risk of failure in the long term. Traditionally, a delay of 3-5 months allows bone conditions to stabilise for optimal osseointegration results, and is seen as a more favourable option because of a higher reported success rate.i A more recent study has reinforced this notion: survival rates for immediate dental implants ranges from 90-95% compared to 95-100% for delayed implants.[iii] This disparity is often agreed on, though a study in China had a much wider disparity than previous research has indicated – 81% for delayed and 53% for immediate.i Many factors can explain this jump, such as the elongated time-span (six years) of the former study, and the location of the implants themselves – this may just be an exception to the overall literature, and not the rule.
Mandible or maxilla?
Implants located in the mandible are more likely to last longer than those in the maxilla. The denser bone structure in the mandible is a firmer framework for implants, providing superior support and stability due to the improved rate of osseointegration.i Because of this, delayed implants are more prevalent in the mandible (47%) than immediate implants (33%), as the latter are often prioritised in the maxilla and anterior regions to minimise soft tissue collapse and preserve the extraction site.i
The difference in cortisol bone density between the mandibular and maxilla regions has led to further disparities in implant survival rate. Those placed in the mandibular region, delayed or immediate, have a 94.7-100% survival rate whereas those in the maxilla have a 90.9-100% rate.iii Overall, this disparity is slight, with both still reporting a predictably high survival rate and positive, long-term outcomes.
Careful considerations
A worry presents itself for patients with dental or medical comorbidities; osseointegration may be more easily achieved with an immediate placement, but several factors should be highlighted to the patients who may wish the faster, less invasive treatment. These include uncontrolled diabetes, autoimmune disease and osteoporosis.[iv] In such cases, delayed placement should be advised for more effective outcomes.
Another issue is sex, with male patients often reporting higher rates of implant failure.i This is attributed to differences in bone density and behavioural patterns – men may be less likely to follow the recommended post-treatment self-care, explaining the higher prevalence of peri-implantitis in this demographic.[v] In this case, the implant being placed immediately or later on has less of an impact on the survival rate.
Direct in decision-making
In an age where patients may prefer the more immediate treatment option so that their dentition is restored as soon as possible, clinicians should affirm the importance of longevity and the longer-term benefits of a delayed implant in many situations. Patient preferences should be accounted for in the decision-making, but these are often second to the individual circumstances and any risk factors for implant failure.
Whether delayed or immediate, measuring implant stability is important for monitoring osseointegration and the longevity of the treatment. To do this with speed and precision, consider the Osstell Beacon from W&H, a non-invasive diagnosis instrument that sends reliable information to your computer via the free OsstellConnect platform. A wireless solution that promotes a more flexible and mobile workflow, using the Osstell Beacon gives clinicians safely stored data that enhances treatment predictability.
Keeping updated on the latest research around implant placement is essential for clinicians to optimise treatment outcomes for their patients. By accommodating the many variables, from implant location to comorbidities and patient preferences, a more holistic decision can be made to ultimately improve the patient’s quality of life.
To find out more about the full range from W&H, visit www.wh.com/en_uk, call 01727 874990 or email office.uk@wh.com
[i] Cheng, Y., Lai, Z. and Yu, W. (2025). Influencing factors and survival rates in immediate vs. delayed dental implant placement: a six-year retrospective analysis. Frontiers in Dental Medicine, 6. doi:https://doi.org/10.3389/fdmed.2025.1563641.
[ii] Masumeh Babayi, Ashtiani, M.N., Amirhossein Emamian, Hosseinali Ramezanpour, Yousefi, H. and Mahdavi, M. (2023). Peri-implant cell differentiation in delayed and immediately-loaded dental implant: A mechanobiological simulation. Archives of Oral Biology, 151, pp.105702–105702. doi:https://doi.org/10.1016/j.archoralbio.2023.105702.
[iii] Patel, R., Cemal Ucer, Wright, S. and Khan, R.S. (2023). Differences in Dental Implant Survival between Immediate vs. Delayed Placement: A Systematic Review and Meta-Analysis. Dentistry journal, [online] 11(9), pp.218–218. doi:https://doi.org/10.3390/dj11090218.
[iv] Dave, M., Rajpal Tattar and Patel, N. (2023). Medical considerations in the ageing implant patient. Oral surgery, 17(1), pp.59–66. doi:https://doi.org/10.1111/ors.12821.
[v] Raed AlRowis, Faris Albelaihi, Hamad Alquraini, Saud Almojel, Alwaleed Alsudais and Razan Alaqeely (2025). Factors Affecting Dental Implant Failure: A Retrospective Analysis. Healthcare, [online] 13(12), pp.1356–1356. doi:https://doi.org/10.3390/healthcare13121356.
