Immediate Loading

For many years, dental implants have been the sole option for many who’ve suffered with lost or bad teeth. Traditional implants involve placing the implants and providing the tooth restoration after 3 to 6 months. This timeframe is needed for bone and gums to attach to the implant. The obvious disadvantage of this procedure is that it leaves the patient with no teeth or with a removable, temporary prosthesis. Many patients find this timeframe too long and uncomfortable and finally decide to forego the idea of dental implants.

In certain cases, immediate loading implant procedures are considered to be a better option than delayed implants. Immediate load implants are exposed to the chewing force immediately after implantation. However, the exact definition of immediate loading may vary from same-day implant loading to a shortly-delayed loading (usually three days to one week) as the manufacturing of a fixed provisory prosthesis might be delayed due to dental lab constraints. Although immediate load implants are gaining recognition as an important option for certain categories of implant patients, there are a number of clinical cases where immediate loading cannot be performed without serious risk of failure. Same day implants are not complex procedures but they do involve the fulfillment of certain criteria. There is a minimum amount of bone that is required and the placed implant has to be in a position to resist a minimum of chewing force. For a single implant the dentist has to adjust the temporary crown in a manner to avoid any kind of force on it. The temporary crown is fixed for aesthetic reasons and not for functionality.

In complex cases where a full arch is involved and more than four to six implants are placed in the maxillary or mandibular arch, the situation is paradoxically easier with the condition that all implants are granted from start a motionless function. The use of a large number of implants. held together by an immediate prosthesis to prevent micromotion at the bone-to-implant interface. is a critical element in this protocol.

Images courtesy of Dr. A. Bernede and Dr. O. Jaren

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Case 2

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