Immediate Loading Implants

 Immediate Loading Implants:

Several classifications of implant loading:

 • Immediate occlusal loading refers to full functional occlusal loading of an implant within 2 weeks of placement.

 • Early occlusal loading refers to functional loading between  2 weeks and 3 months of implant placement.

 • Nonfunctional immediate restoration refers to implant  prostheses placed within 2 weeks of implant placement  with no direct functional occlusal loading

• Nonfunctional early restoration refers to implant prostheses delivered between 2 weeks and 3 months from implant placement.

 • Delayed occlusal loading refers to the restoration of an implant more than 3 months after placement.

Immediate Loading for Single-Tooth Restoration

•  Studies of single-tooth restoration and immediate loading have shown good success rates. 
• on these single-tooth restorations placed into immediate occlusion via provisionalization with success rates similar to those implants restored with light or no occlusal forces. 
• The presence of a provisional  crown throughout the healing phase,  which allowed the sculpting of the interdental papilla and the attached gingiva. 
• Given the recent advances and research in this area.However, the immediate  loading of a single-tooth restoration is clearly a viable option  for  patients.

Immediate Loading of the Fixed Prostheses 

•  Research in the area of fixed or multiple-tooth replacement with immediate loading has been divided into prostheses  placed in the mandible and those placed in the maxilla. In  the early studies of mandibular multi-tooth restorations with  immediate loading, one technique placed additional or interim  implants to initially support the prosthesis while the remaining implants underwent the healing phase. 
•  In the edentulous or partially edentulous maxilla, significantly more implants must be placed to obtain primary stability of an immediately loaded prosthesis. Although many studies have suggested a requirement of 8 to 12 implants, several studies have shown similar success rates with 5 to 8 implants.The literature debates, with varying results, the surface morphology of implants best suited to placement in  the decreased bone density of the maxilla.
• Immediate loading in both the edentulous or partially edentulous maxilla and mandible is a viable treatment option. 

Immediate Loading of Over-Denture Prostheses 

•  No studies exist that display true immediate loading protocols  for over-denture prostheses as defi ned earlier. However, there  is support for early occlusal loading with over-dentures. True  immediate loading in these cases may not be possible due to  the need for prosthetic development of bar attachments in many instances. A recent study placing over-dentures into occlusal loading at 4 days supported by a bar system showed  high success rates. 
• Early functional loading in these studies referred to a  protocol usually consisting of implant loading at approximately 3 weeks with either a ball attachment or bar-clip assembly. Immediate early functional loading referred to placement  of the prosthesis within 5 days. In the studies that attempted  the earliest functional loading the bar-clip attachment was the restorative method of choice. 
•   The majority of the opposing dentitions in these studies were complete dentures and some implant-supported prostheses; there was little difference in success rates between these opposing dentitions. 
• Studies have also suggested that implants for early loading with over-dentures should be splinted with the bar-clip  attachment to prevent axial rotation and micromotion. However, given the success rates with early loading of ball  attachment implants it cannot be factually stated that splinting these implants is a requirement for success. 
•  A flapless procedure was done with the placement of six one-piece, single-stage implants from which an immediate impression was taken for a bar constructed that day, passively placed to support  a clip-retained full lower denture. 

Immediate Placement and Loading of Implants in Extraction Sites 

• The overall reasoning behind immediate restoration of these implants is to aid in restoration of soft tissue aesthetics by gingival contouring as well as removing the need for temporary removable  prostheses.