Immediate loading – Indications and planning

The topic of implants with immediate loading has always been very present when it comes to dental implants. The term is related to pressure, i.e. loading on the newly installed implant, therefore immediately after surgery. It is important to note that the decision on whether or not to perform immediate loading on the implant should be made by the implant dentist. Assuming that this is the main desire of all patients, it is the implant dentist who must certainly assess the conditions conducive to the use of this technique.

Currently, implant surgery is studied beforehand by the implant dentist (dental implant specialist) through the patient’s panoramic X-ray and CT scan. It is therefore possible to assess whether the patient has favorable bone conditions for the use of this technique. However, it is at the time of implant surgery, by locking the implant, that it is possible to guarantee that the immediate loading technique can be carried out. In this way, the professional can also change the technique used to make the prosthesis if the necessary implants are not locked during surgery. Although the bone structure is studied beforehand through examinations, it is only during surgery that the real bone situation can be gauged.

How is immediate loading surgery with dental implants performed?

Surgery is performed to install dental implants in the jawbone. The surgery should take place like a conventional dental implant surgery. Prior to the surgery, plans are made for an immediate temporary prosthesis, so that the patient will never be without teeth. There are prerequisites for using the installed implant:

• Sufficient torque (greater than 35 N.cm)
• Long implant (longer than 11 mm)
• Implant with sufficient diameter: Larger than 3.75 mm
• Planning a prosthesis compatible with the implant‘s ability to withstand forces
• Sufficient number of implants
• Good distribution of implants in the arch
• Patient without bruxism symptoms
• People without symptoms of diseases that compromise tissue and bone healing (e.g. diabetes)
• Non-smoking patient (smoking greatly reduces the chance of implant success)

This means that not all cases are good for immediate loading. Sometimes, only during implant installation will we be able to tell if the implant has met the requirements for immediate loading. Therefore, in some cases immediate loading can be aborted to allow the implant to heal in a conventional way (between 3 and 6 months).

If the surgery goes well, you can then start on the provisional or even definitive prosthesis, which requires molds and measurements of the arch. Immediate loading is usually carried out with a temporary prosthesis and, after the implants and gums have healed (between 3 and 6 months), the definitive prosthesis is made.
Watch the video below where we show the total implant surgery and the installation of the protocol prosthesis.

Although it is possible to carry out the treatment with the definitive material initially, we consider it better to make a temporary prosthesis, as the gums must swell and the bone changes shape during the initial three months of healing after surgery.

Best material for fixed prostheses

Currently, the most modern material for fixed prostheses is zirconia. Zirconia is a biocompatible material in line with the biological dentistry trend, which seeks to avoid the use of metals in dental treatments. It is also highly resistant and can be designed using computer graphics, which gives a much more natural aesthetic result compared to other types of dental prosthesis materials.

If you have any questions, please contact our team.

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