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Dental implants are increasingly used in dental restorations. Traditionally, the implant is placed in the jawbone and allowed to heal for several months before a crown, bridge, or denture is made. Today, immediate loading implants are common. This means that you will be placed with a temporary tooth for 48 hours and the implant site will be allowed to heal. Once the implant has fully integrated with the bone, the temporary crown is replaced with a porcelain crown.
A temporary tooth is attached to the implant immediately after it is placed in the jawbone. This temporary tooth is usually carefully shaped so that it does not come into contact with the opposing tooth and is purely for cosmetic purposes.
Immediately loaded implants are also functional, meaning they will contact the opposing molars and can be used for eating and drinking. Immediately loaded implants are often used when several front teeth are missing and the implants are securely attached, such as in a denture.
A typical example is engineering. All-on-4 implant lower jaw, combining all the implants while they heal. This way, if a force is placed on one implant, the force will be distributed across all the implants because they are connected together.
The benefit that customers receive from dental implants is that the teeth look natural after the Implant fuses with the bone.
The concept of immediate loading of implants is not new; it has been used since the 1960s when modern implant dentistry was still in its infancy. However, advances in imaging technology have greatly aided the success of this technique.
1. How does an immediate loading implant work?
3D CT scanners can help dentists place implants into the jawbone accurately. Implant placement aids can accurately measure the torque applied to each implant. These technologies allow implant placement to be performed under ideal conditions that are consistent with the condition of the jawbone.
Healing time plays a major role in traditional implant placement because it takes months for osseointegration to occur. Osseointegration is the process by which bone tissue in the jawbone integrates into and around the implant, forming a connection and holding the implant in place.
Studies have shown that implants must not be disturbed during the osseointegration process; This must be done because even a small impact can affect the bond between the implant and the bone. Removing this impact will ensure the success of the implant placement on the same day. This can be done by connecting the implants or ensuring that the teeth on 1 implant do not come into direct contact with the opposing molars.
While it is important to control the forces applied to the implant during the healing period, some studies have shown that immediate loading has certain benefits, such as promoting the growth of new bone cells around the implant. However, these forces must be within precise parameters to ensure implant success.
2. Implantation process
2.1 Consulting and diagnostic testing
Every implant surgery requires a detailed plan; this process begins with a consultation with your doctor. Your doctor must know about your oral health and general health before ordering diagnostic tests. These tests include scans, X-rays, and CT scans. The results of these tests will be analyzed and will be used to assess the quality of the bone at the implant site. This will give you a better understanding of the treatment plan.
The bone at the implant site must be sufficient to support the implant and ensure that the tooth heals naturally. If there is insufficient bone support, bone grafting must be performed at that site before or immediately after the implant is placed.
The gum tissue surrounding the implant must also be sufficient to ensure aesthetics. You will want the replacement tooth to look like it is growing naturally above the gum line. Gum tissue can also be grafted from another location in the mouth if needed. During this stage, our dentist will also determine the ideal location for the implant and choose the size of the implant.
2.2. Surgery
To help the surgeon determine the position of the implant, a guide will be made to determine the ideal position and orientation of the implant. Our surgeon will insert the implant into the jawbone using this guide. Typically, this implant is done very quickly under local anesthesia. The temporary tooth will be connected to the Implant immediately after the surgery is completed.
3. Benefits and risks of immediate loading implants
3.1. Benefits
+ Reduced treatment time. Restoration of anterior teeth is almost immediate. With traditional implant methods, tooth restoration usually takes 3–6 months.
+ Only one surgery is required. The implant, abutment and temporary crown will be done in 1-2 days. Therefore, the treatment time will be reduced.
+ Gum tissue is more compatible with the crown. Typically, a cylindrical healing plug (pictured below) can be placed over the implant to shape the gum tissue. With an immediate-loading implant, the gum tissue can be shaped with a temporary tooth (just like a permanent tooth).
+ Avoid wearing removable dentures. Immediate loading implants will reduce the psychological and physical impact of tooth loss by replacing temporary teeth, eliminating the need to wear removable dentures.
3.2. Risks
The surgeon must take precautions to ensure the implant does not move during integration with the bone.
This technique is only suitable for specific situations. Immediate dental implants are best suited for anterior teeth with healthy posterior teeth on both sides. Immediate dental implants are also suitable for cases of total mandibular loss with stable bone structure. Immediate dental implants are not ideal for cases of total maxillary loss because the maxillary bone tends to be lighter and thinner than the mandibular bone, and replacing all the teeth in the maxillary jaw where the bone tends to be lighter and not strong enough.
All implant surgery carries a small amount of risk. Several factors can lead to failure in the short term if the implant does not integrate with the jawbone or the surrounding gum tissue becomes infected. The risk of infection remains in the long term and failure is always possible if the implant is not given enough time to heal or is overused.
4. Alternative solutions
It is very important to take good care of the area around the implant for several months after surgery. This helps prevent infection and ensures that the implant is not subjected to excessive stress.
If proper care is not possible, you should consider a traditional two-stage implant procedure. First, the implant is placed in the jawbone and allowed to heal for several months, during which time the bone is covered by gum tissue and protected from the elements. A second stage is then performed to expose the implant, connect it to the abutment, and a crown or bridge.
Immediate loading dental implants also have a short treatment time but are more affordable in the long run than removable dentures and bridges.
5. Suitable subjects for immediate loading implant placement
The ideal candidate is someone who is in good general and oral health. You will not be suitable for treatment if you smoke, have factors that affect or reduce your immune system, or are being treated with bisphosphonates. These drugs increase the risk of osteonecrosis even after minor surgery, especially in people who receive them intravenously as part of cancer treatment. People who are given low doses of bisphosphonates, for example for osteoporosis, do not have a risk of osteonecrosis.
6. Same-day implants, early or late loading and success rate
Once the implant is placed, new bone cells will grow around it, which is important because it will help the implant anchor to the jawbone and stay in place. It was previously thought that placing implants under immediate loading during the healing period would increase the risk of failure; implants need to be left in place for 3 to 6 months to ensure long-term success.
However, recent studies have shown that initial implant stability determines success. Bone thickness determines initial strength, the force applied to the implant, and the number of implants connected. Studies have concluded that there is no significant difference in the success of immediate implant loading versus waiting for a healing period before placing the implant.
Single implants should be given a waiting period to minimize the risk of shifting and failure. This is why immediate loading of single implants is only used for anterior teeth—the temporary tooth is kept completely out of contact with the other opposing teeth while it heals.
Conclude
Same day implant placement can be useful in certain situations, but the patient must be carefully assessed for suitability. Our implantologists are fully qualified and experienced to perform the implant placement with precision, so the risk of any adverse effects on the implant is eliminated. If you are not a candidate for immediate loading of implants, you should consider alternative options, even if the treatment is longer.
