At 3 Step Smiles, we use the immediate loading technique, otherwise known as Immediate Function. Often in the field of dentistry, we use this term with our patients, and they immediately respond; “what’s that?”. This is one of the many questions people have about this innovative technique, and in this post, we will try to answer them all!
What is immediate loading?
In the traditional approach, dental implants are typically placed first, followed by a waiting period of 3 to 6 months for osseointegration to occur before the crown is placed.
Immediate loading, on the other hand, involves placing the implant and attaching a fixed provisional dental piece (not removable) immediately after the surgery is completed or within 24 hours.
In certain cases, immediate implantation is performed, where damaged teeth are extracted and the implant is placed simultaneously. For aesthetic areas or full oral rehabilitation, crowns or temporary dental pieces can also be placed concurrently.
This technique addresses the growing demand from patients for faster treatment and quicker restoration of functional teeth. By eliminating the waiting period, which often deters individuals from pursuing implant treatment, immediate loading offers a prompt solution.
How is the procedure?
The patient leaves the clinic with their best smile, without having to wait months to be able to show it off. After three months, the dentist will fit the definitive crowns, which have better material and aesthetic quality than the temporary ones.
If we work well with immediate loading, we can achieve much better results in our definitive fixed teeth. Critics of the immediate loading technique argue that loading implants before osseointegration increases the risk of the treatment. There is no doubt that this is an advanced implantology technique that requires extensive experience on the part of the practitioner, but it is neither dangerous nor counterproductive.
The immediate loading technique is made possible by scanners and software that allow 3D planning of the procedure. When the patient’s mouth can be virtually recreated from digital images, the dentist works with maximum reliability and safety. The final result of the surgery is completely predictable. In other words, computer simulation of the operation allows for maximum precision when placing the implant.
How can I determine if I am a suitable candidate for immediate loading?
While immediate loading can be a life-changing technique for certain individuals, it may require a preliminary assessment for patients who exhibit some of the following characteristics:
- Patients with a medical condition (e.g., diabetes) that impacts their immune system or the body’s healing capacity.
- Patients with periodontal issues.
- Patients lacking sufficient bone density to support the implant.
- Patients who smoke.
What do I have to take into account?
In order to ensure the success of immediate loading, several factors need to be taken into consideration.
Firstly, having sound professional judgment is crucial for obtaining an accurate diagnosis. As with any specialized field, the dentist’s experience and the number of procedures performed are influential factors in the treatment’s success. Generally, a higher level of professional experience correlates with a higher success rate.
It is important to note that the osseointegration process relies on achieving good primary stability during implant placement, as well as maintaining secondary stability after osseointegration has occurred. The following factors influence these aspects:
- Quality and quantity of the bone
- Adaptation of the implant to the osteotomy
- Design and shape of the implant
- Oral health and dental maintenance of the patient
All of the above are very important because they condition the possibility of carrying out immediate loading of implants. To see if a patient meets the requirements for immediate loading, primary stability measurement systems have been developed, such as the Perio-Test or the Ostell.
What are the advantages of immediate loading?
Numerous studies have conducted positive evaluations of the immediate loading technique, concluding that it demonstrates predictability in terms of osseointegration and marginal bone maintenance. Some of the notable advantages include:
Restoration of functionality
Immediate loading allows for the restoration of normal chewing and speech within the first 24 hours after tooth extraction. While complete normal chewing is achieved once the definitive crowns are in place (subject to the patient’s own apprehension), the initial temporary fixed prosthesis provides functional benefits.
Elimination of removable prostheses
Within 24 hours, patients can wear a temporary fixed prosthesis, eliminating the need for a removable prosthesis. This spares patients the discomfort associated with removable prostheses, such as mobility, sores, speech difficulties, and altered taste perception. This facilitates gradual adaptation to subsequent definitive fixed teeth, preserving self-esteem and confidence throughout the process.
Shortened waiting time
Immediate loading reduces or even eliminates the waiting period to have new fixed teeth in the mouth, significantly enhancing the patient’s quality of life.
Reduced sessions and surgical interventions: By avoiding second-stage surgery, the number of sessions and surgical interventions can be minimized, leading to increased patient acceptance.
Enhanced comfort and stability
Complete oral rehabilitations benefit from the stability provided by immediate loading, avoiding the loss of additional teeth. The fixed prosthesis does not exhibit mobility or instability, ensuring a high level of comfort and security for the patient.
Natural gum adaptation
From the moment the provisional crown is placed, the gum begins to take shape around it. When the definitive prosthesis is installed, the gum adapts seamlessly. This optimal aesthetic outcome further enhances patient satisfaction.
In summary, immediate loading offers functional, aesthetic, and psychological benefits, enabling a more efficient and comfortable dental restoration experience.
Studies speak for themselves
Over the past 30 years, numerous long-term studies have been conducted, with patient follow-ups ranging from 5 to 10 years. These studies consistently report implant survival rates (implant success) ranging from 97% to 100%. This indicates that the new teeth are highly likely to integrate successfully within the patient’s mouth without rejection.
In summary, our patients can benefit from increasingly less invasive and shorter implant treatments. However, it is important to note that immediate aesthetics should not always be equated with immediate loading.
Immediate loading should not be performed as a routine practice, but rather as a carefully considered approach for patients who meet the necessary requirements and are suitable candidates for this technique. It is essential to approach immediate loading logically and with a thorough assessment of patient suitability.
At 3 Step Smiles Dental Clinic, we are prepared to offer you the best treatment with the greatest safety. Our 100% Digital workflow, our 3 Step Smiles system, and our years of experience give us the security and confidence to face any challenge upon us.