(800) 854-7256 Main | (855) 289-9657 Case Pickup

The Do’s and Don’ts of Immediate Loading or Provisionalization of Dental Implants

The Do's and Don'ts of Immediate Loading or Provisionalization of Dental Implants - Dental CE Course
Launch Course

Course Objectives (2 CE Credits)

Darrin Wiederhold, DMD, M.S.

With manufacturers touting the success rates of immediately loaded dental implants, clinicians may find themselves under increasing pressure to meet patient expectations for a same-day restorative solution — whether temporary or final — upon implant placement. Doing so, however, may endanger osseointegration in certain clinical situations. As with any surgical procedure, there are selection criteria that, if heeded, can help maximize the chances of success. Conversely, there are guidelines that clinicians ignore at their own peril. Dr. Darrin Wiederhold outlines the Do's and Don'ts of immediate loading with an analysis of the following concepts:

  • Distinguishing between “immediate loading” and “immediate non-functional provisionalization”
  • Measuring initial stability
  • Assessing bone quantity and quality
  • Identifying evidence of parafunctional habits or metabolic disorders
  • Splinting in multi-unit cases
  • Determining intra-arch space

Summary

As the cosmetic expectations of implant patients increase, clinicians are strongly motivated to meet the demand for immediate loading or provisionalization of freshly placed implants. For long-term success, however, it is critical that esthetic concerns do not outweigh factors used to promote successful osseointegration. Only after assessing the relevant clinical parameters and implementing the appropriate precautions should a clinician immediately provisionalize or load a newly placed implant.

CAUTION: When viewing the techniques, procedures, theories and materials that are presented, you must make your own decisions about specific treatment for patients and exercise personal professional judgment regarding the need for further clinical testing or education and your own clinical expertise before trying to implement new procedures.


References

  1. Attard NJ, Zarb GA. Immediate and early implant loading protocols: a literature review of clinical studies. J Prosthet Dent. 2005 Sep;94(3):242-58.
  2. Balshi TJ, et al. A prospective analysis of immediate provisionalization of single implants. J Prosthodont. 2011 Jan;20(1):10-5.
  3. Block M, et al. Single tooth immediate provisional restoration of dental implants: technique and early results. J Oral Maxillofac Surg. 2004 Sep;62(9):1131-8.
  4. Block MS, et al. Prospective evaluation of immediate and delayed provisional single tooth restorations. J Oral Maxillofac Surg. 2009 Nov;67(11 Suppl):89-107.
  5. Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. Int J Oral Maxillofac Implants. 2004;19 Suppl:43-61.
  6. Davidoff SR. Late stage soft tissue modification for anatomically correct implant-supported restorations. J Prosthet Dent. 1996 Sep;76(3):334-8.
  7. Degidi M, et al. Five-year outcome of 111 immediate nonfunctional single restorations. J Oral Implantol. 2006;32(6):277-85.
  8. Kinsel RP, Lamb RE. Tissue-directed placement of dental implants in the esthetic zone for long-term biologic synergy: a clinical report. Int J Oral Maxillofac Implants. 2005 Nov-Dec;20(6):913-22.
  9. Kourtis S, et al. Provisional restorations for optimizing esthetics in anterior maxillary implants: a case report. J Esthetic Restor Dent. 2007;19(1):6-16.
  10. Wismeijer D, et al. ITI Treatment Guide, Vol. 4: Loading Protocols in Implant Dentistry: Edentulous Patients. 2010. Berlin: Quintessence Publishing Co, Ltd.
Prev Course
Next Course

Subscribing Has Its Perks!


Offers on products you may already use
Introductory offers on new products
Educational materials
Top