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 and how is it done?
The traditional way of placing implants is to put the dental implant first, and after a period of 3 to 6 months, the crown is placed. This period of time is called osseointegration.
Immediate loading consist of placing the implant and screwing a provisional dental piece onto it (always fixed, not removable) as soon as the surgery is finished or within 24 hours.
In some cases, we also do the immediate implant, where everything is done at the same time: extraction of the damaged teeth and placement of the implant. If the implant is in an aesthetic area or if it’s a full oral rehabilitation, we also place the crowns or temporary piece.
The technique was developed in response to patients’ growing demand for quicker treatment and faster time-to-teeth. With it, we “skip” this waiting time, which for many people is a reason for not doing an implant treatment.
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 obtain much better results in our definitive fixed teeth. The 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 possible thanks to 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, the computer simulation of the operation allows maximum precision when placing the implant.
How could I know if I’m suitable for immediate loading?
Although Immediate loading is a life-saving technique for some, it may need a previous study for patients who meet some of these characteristics;
- Patients with a disease (e.g. diabetes) that affects their immune system or the body’s ability to heal itself.
- Patients with periodontal problems.
- Patients who do not have enough bone mass to place the implant.
- Patients who smoke
To ensure the success of immediate loading, there are several factors to take into account. The first is to have good professional criteria in order to obtain a good diagnosis. As in any specialty, the experience of the dentist and the number of interventions performed will be influential factors in the success of the treatment. The longer the professional experience, the higher the success rate tends to be. We know that the osseointegration process depends on having good primary stability (implant placement) and secondary stability (once the implant has osseointegrated and how it is maintained over time). These depend on:
- The quality and quantity of bone
- Adaptation of the implant to the osteotomy
- Design and shape of the implant
- The patient’s oral health and dental maintenance.
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 positively evaluated the immediate loading technique, concluding that it is predictable in terms of osseointegration and marginal bone maintenance. Among the advantages we can highlight some of them:
- Immediate loading allows restoring the functionality of the dentition; recovering normal chewing and phonation in the first 24 hours after tooth extraction. Obviously, it is not possible to chew normally until the definitive crowns are put in place (often this is also due to the patient’s own fear of doing so).
- In less than 24 hours you are already wearing a temporary fixed prosthesis, without the need to wear a removable prosthesis. Therefore, the patient does not have to suffer the discomfort of wearing a removable prosthesis (mobility, sores, speech difficulties, loss of taste in food, etc). This facilitates the progressive adaptation to the subsequent definitive fixed teeth and means that the patient does not lose self-esteem and confidence during the process.
- It makes it possible to shorten or even eliminate the waiting time to have new fixed teeth in the mouth, which leads to a notable increase in the patient’s quality of life.
- It can reduce the number of sessions and surgical interventions (avoiding second-stage surgery) which increases patient acceptance.
- In the case of complete oral rehabilitations, it avoids the loss of more teeth and provides great comfort. The prosthesis has no movement capacity, it is not unstable and does not wobble, so it usually provides great security to the patient.
From the first minute, when the provisional crown is placed, the gum takes shape from this temporary piece. When the definitive prosthesis is placed, the gum takes it without any problems. Moreover, from an aesthetic point of view, the result is optimal.
In the last 30 years, several long-term studies have been carried out, with patient follow-ups of between 5 and 10 years. All of them have established survival rates (implant success) of between 97% and 100%. In other words, the new teeth are not rejected in the patient’s mouth.
In short, our patients will be able to benefit from increasingly less invasive and shorter implant treatments. But don’t forget that immediate aesthetics are not always synonymous with immediate loading.
Immediate loading should not be done out of habit, but rather a logical immediate loading, with patients who meet the requirements and are appropriate for this technique.