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CONSIDERATIONS UPON IMMEDIATE LOADING OF IMPLANTS
As demonstrated by numerous documented studies, success rates for immediate implant loading are as high as with conventional loading (90-95%). These studies accomodate a high number of fully edentulous patients (i.e. non-dentate), who underwent implant therapy with same-day protocols; namely extraction of all teeth, simultaneous placement of fixtures in post-extraction sockets and loading of implants with same-day provisional screw-retained fixed prosthesis followed by delivery of definitive restoration within 7-10 days
Prerequisites for predictable immediate loading are
- Uncompromised medical history
- Excellent primary stability of implants at site (insertion torque)
- Favourable occlusal forces
- No indication of para-function (i.e bruxism)
- Meticulous curetting of lesions (i.e. cysts) in post-extraction sockets
- Sufficient post-extraction bone volume (>2mm)
- Sufficient zone of attached gingiva
Advantages of Immediate loading
- Faster procedure as compared to conventional loading
- Favourable healing of soft tissues around the fixed prosthesis
- Gum height and outline maintained significantly better as compared to conventional loading
- Considerably minimal to moderate symptoms (i.e. pain-swelling)
Disadvantages of Immediate Loading
- Technically sensitive treatment
- Additional expenses
If not all aforementioned indications occur, immediate loading can still be implemented with some suitable modifications such as simultaneous gum/bony enchancement and/or placement of more implants and solely delivery of provisional fixed prostheses, that should remain 2-4 months before advancing to the definitive restorations.