Placing an implant on the same day a tooth comes out sounds like the obvious choice, because it saves a surgery and several months. In carefully chosen sites it works well. Waiting for the socket to heal is slower but more forgiving, and research suggests it carries fewer complications. Which is right for you depends on the bone, gum and health of that particular site.
Four points in time, not two
Implant dentists often talk about "immediate" and "delayed" as if they were the only options, but the international literature describes four timing types after an extraction (summarised by Chen and Buser, International Journal of Oral and Maxillofacial Implants, 2009):
- Type 1, immediate: the implant goes in at the same appointment as the extraction.
- Type 2, early with soft tissue healing: the gum is left to close over the socket for a few weeks first.
- Type 3, early with partial bone healing: the socket is given a few months so that some new bone forms.
- Type 4, late: the implant is placed once the site has fully healed, often many months later.
Having these in-between options matters. A site that is not ready on the day of extraction does not always need to wait for full healing.
Survival is high either way, but the details differ
Most studies report that more than 95% of implants placed after an extraction are still in place at follow-up, whichever timing is used. The comparisons between immediate and delayed placement are less tidy.
A 2022 systematic review in Clinical Oral Implants Research (Garcia-Sanchez and colleagues) pooled randomised trials and found no significant difference in survival between immediate and delayed implants, with immediate implants surviving at about 97%. The same review found immediate implants had roughly three times as many early complications and twice as many later ones. An earlier 2017 meta-analysis in the International Journal of Oral and Maxillofacial Surgery (Mello and colleagues), which included a wider range of studies, reported survival of 98.4% for implants in healed sockets compared with 95.2% for immediate implants, and advised caution with immediate placement.
Put together, the evidence suggests immediate implants can do very well in the right case, but they leave less room for things that are not ideal.
Front teeth bring the gum into the decision
For a front tooth, survival is only part of the picture. The gum line has to look natural next to the neighbouring teeth. Chen and Buser found that the gum margin often recedes after immediate placement, with risk linked to thin gum tissue, a thin or damaged bone wall on the outer side of the socket, and an implant positioned too far towards the lip. Early placement was associated with less recession. A 2017 review by Buser and colleagues in Periodontology 2000 recommends choosing between all four timing options based on a careful assessment that includes a 3D cone beam CT scan.
When same-day placement may suit
Immediate placement is more likely to be considered when:
- the tooth can be removed without breaking the surrounding bone walls
- there is no active, uncontrolled infection at the site
- there is enough sound bone beyond the socket for the implant to be held firmly on the day (called primary stability)
- for front teeth, the gum is reasonably thick and the outer bone wall is intact
If the implant is firmly held, a temporary tooth can sometimes be fitted soon after, which is a separate decision covered in our guide to same-day implants.
When waiting is the better plan
Healing first is usually preferred when there is a large infection, when the bone walls are thin or lost, when the gum is very thin, or when general health factors such as smoking or poorly controlled diabetes raise the risk. Waiting also allows bone grafting to be done and assessed before the implant goes in, which our article on bone grafts and sinus lifts explains. A recommendation to wait is part of careful planning, not a delay for its own sake. You can read what to expect while the socket heals in our extraction recovery guide.
Timing has little effect on cost
The fee for an implant depends far more on whether grafting is needed, how complex the site is and what kind of crown goes on top than on when the implant is placed. As a typical Australian market range, not a Lumi fee, a single implant with its crown commonly costs about $4,000 to $7,000. For Lumi's pricing and any current offers, see our current deals or the dental implants page.
Questions patients ask about implant timing
Will I leave with a tooth if the implant goes in the same day?
Sometimes. A temporary tooth on the implant is only possible if it is held firmly enough. Otherwise a removable temporary or a bonded temporary tooth can fill the gap while it heals.
Can the plan change on the day?
Yes. If the bone turns out to be thinner or more damaged than the scan suggested once the tooth is out, the dentist may switch to grafting the socket and placing the implant later.
Does the wait make the implant last longer?
Not necessarily. Once an implant has healed in, long-term care such as cleaning, check-ups and not smoking matters a great deal. Our guide to implant aftercare covers this.
If you have a tooth that may need replacing, our dentists at Lumi Dental in Melrose Park can assess the site with a 3D scan and explain which timing suits it. You may also find it useful to compare an implant with a bridge or denture before you decide.
