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Immediate loading implants—an artificial titanium root inserted into the jawbone and used to support lost teeth—are increasingly used in tooth restoration. Usually, the implant will be buried in the jawbone to wait for healing for several months before making a crown, bridge, or denture. Today, the implementation of immediate load-bearing implants is widespread. This means you will have an implant and a temporary tooth within 48 hours and will let the implant site heal. After the latest implant techniques has integrated well with the bone, the temporary crown will be replaced with a porcelain crown.

load-bearing implant

Temporary teeth are attached to the implant right after it has been implanted into the jawbone. This temporary tooth is usually carefully shaped so that it does not come into contact with the tooth on the opposite side of the mouth and is purely for cosmetic purposes.

Immediate loading implants are also functionally responsive, meaning they will come into contact with the opposing molars and can be used for eating or drinking. Immediate-load implants tend to be used when some anterior teeth are lost, and the implants are firmly connected, such as in a denture. A typical example is the mandibular “all-in-four” technique, which combines all the implants while waiting for healing. This way, if a force could damage an implant, the power would be distributed across all the implants because they are interconnected.

The benefits to customers from implanted teeth are teeth that look natural once the implant fuses with the bone. This sounds very appealing, as it increases the benefits and potential risks of immediate loading implants compared to traditional methods, which are only suitable for some.
The concept of instant-loading 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 this technique’s success.

1. How does an instant loading implant work?

A computerized tomography machine can help the dentist insert the implant in the jaw bone accurately. Support equipment during implant placement will help accurately measure the torsion force on each implant. These technologies allow implant placement to be carried out in ideal conditions suitable for the state of the jawbone.

Healing time plays a vital role in traditional implant placement because it takes many months for the bone integration process to take place. Bone integration is the process by which the bone tissue in the jawbone integrates onto and around the implant, forming a connection and holding the implant in place.

Studies have shown that the implants mustn’t be impacted during the ossification process; even a small impact can select the bonding between the implant and the bone if removed. This impact will ensure success in implant placement within the day. This can be done by connecting the implants or ensuring that the teeth on a single implant are not in direct contact with the opposing molars.

Although it is essential to control the force exerted on the implant during the healing period, some studies have shown that immediate application has certain benefits, such as promoting the growth of new bone cells around the implant. Still, these forces must be within the correct parameters to ensure implant success.

2. Implant procedure.

2.1 Counseling and diagnostic testing.

All implant surgery requires a specific plan; this process begins with an examination and consultation with a doctor. Your doctor must know about your teeth and general health before ordering diagnostic tests. These tests include scans, x-rays, and CT scans. The parameters from the above test will be analyzed and are a factor in evaluating the bone quality at the implant site. Clients will have the opportunity to watch these films to understand the treatment plan better.

The bone at the implant site must be enough to support the implant and ensure that the tooth naturally recovers. If the bone support is insufficient, a bone graft must be performed at that location before placing the implant. The gum around the implant must also be enough to ensure aesthetics. You will want the replacement tooth to look like it is naturally protruding above the gum line. The gum tissue can also be grafted from another location in the mouth if needed. During this phase, our dentist will also determine the ideal placement for the implant and choose the implant’s size.

Once the dentist has enough information, planning will be carried out; in some cases, if necessary, the dentist will conduct a surgical trial before surgery to determine the exact location where an implant is needed.

2.2. Surgery.

To help the surgeon locate the implant, a guide will be made that will indicate the ideal position and direction of the implant. Our surgeon will insert the implant into the jawbone using this guide trough. Usually, implant placement is done very quickly through local anesthesia. Temporary teeth will be connected to the implant as soon as the surgery is completed.

load-bearing implant

3. Benefits and risks of immediate load-bearing implants:

3.1. Benefit.

  • Reduce treatment time. Almost immediate anterior tooth restoration With the immediate loading implants method, tooth restoration usually takes 3–6 months. As a result, many people will choose a faster but less effective long-term solution to restore teeth, such as a bridge, and miss the opportunity to place an implant with the long-term benefit of preserving bone.
  • Requires only one surgery. immediate loading immediate loading implants, connecting posts, and temporary crowns will be performed on the same day. Therefore, the treatment time will be reduced. Exposing the implant after 3-6 months is an unnecessary delay before attaching the abutment and crown.
  • Gum tissue is better compatible with the crown. Usually, a cylindrical healing node (pictured below) can be placed over the immediate loading implants to shape the gum tissue. With Instant Loading Implants, gum tissue can be shaped with temporary teeth (akin to permanent teeth).

Therefore, the gum tissue will be compatible with the crown and achieve high aesthetics.

Avoid wearing removable dentures. Immediate load-bearing immediate loading implants will reduce the client’s psychological and physical impact of missing teeth by having temporary replacement teeth, so there’s no need to wear removable dentures, and you won’t either. There are gaps in the mouth while it heals.

3.2. Risks.

  • Immediate load-bearing immediate loading implants placement is an exact tie. The surgeon must take precautions to ensure the implant does not move during its integration with the bone.
  • This technique is only suitable for specific situations. The immediate loading implants  must be firmly planted in the jawbone and must be able to withstand a force of 35 Ncm. Immediate-loading implants are best suited for anterior teeth and have healthy posterior teeth on both sides. Immediate-loading implants are also very suitable in cases where the entire lower jaw has lost teeth but has a complex bone structure. Immediate-load implants are not ideal for total maxillary tooth loss because the maxillary bone tends to be lighter and thinner than the lower jaw bone, and the replacement of all teeth in the upper jaw is where the bone tends to be more lightweight and not strong enough.

All implant surgery carries a small fraction of the risk. Several factors can lead to implant failure in the short term if the implant fails to integrate with the jawbone or the surrounding gum tissue becomes infected. The risk of infection remains in the long run, and there is always the possibility of failure if the dental implants is not given enough time to heal or is overloaded.

4. Alternative solutions.

Taking good care of the area around the implant for several months after surgery is extremely important. It helps prevent infection and ensures the implant is not subjected to too much force.

If proper care cannot be guaranteed, you should consider immediate loading implants using a two-stage technique. First, the implant is placed into the jawbone and waits a few months to heal, during which time the bone is covered with gum tissue and protected from the elements. Stage two is then performed to expose the implant, connecting it to the abutment and crown.

The immediate-load implant alternative also has a short treatment time but is more affordable than removable dentures and bridges in the long run.

5. Objects suitable for immediate loading implants.

Ideal candidates are those with good oral health and overall health. You will not be suitable for treatment if you smoke, have factors that affect your immune system or lower your body’s immunity, or are being treated with bisphosphonates. These drugs increase the risk of bone necrosis after even minor surgery, especially in those who have received intravenous infusions as part of cancer treatment. People who are given low doses of bisphosphonates, for example, in osteoporosis, do not have an increased risk of bone necrosis.

Evening grinding and clenching habits can also negatively affect the immediate loading implants by placing too much force on the crown. Customers who choose the method of implant placement must perform good oral hygiene because if they do not clean well, it will create an opportunity for the tissues around the implant to become infected, similar to gum disease—also known as peri-implant periodontitis. This condition can also lead to implant failure if not treated promptly.

6. Implant of the day, early or late loading, success rate.

As soon as the immediate loading implants is inserted, new bone cells grow around it, which is very important because it will help the implant attach to the jaw bone and be kept in a particular position. In the past, people thought that putting the implant under immediate load during the healing time would increase the risk of failure; the implants need to be kept in place for 3 to 6 months to ensure long-term success.

However, many recent studies have shown that the initial stability of the immediate loading implants will determine its success. The thickness of the bone determines initial strength, the forces applied to the implant, and the number of connected implants. The study concluded there was no significant difference between the success of immediate loading implants and waiting for a period to heal before placing an immediate loading implants.

Single implants should have a waiting period to minimize the risk of movement and failure. This is why immediate implants for single immediate loading implants are only used for anterior teeth—temporary teeth are kept entirely out of contact with other opposing teeth while waiting for healing.


Same-day immediate loading implants placement can be helpful in specific situations, but clients must be carefully evaluated for appropriateness. Our implant doctors are fully qualified and experienced to perform implant placement correctly, so the risk of any adverse impact on the implant is eliminated. If you are not a candidate for immediate loading implants, you should consider alternatives, even if the treatment lasts longer.


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Managed by Doctor TRAN NGOC TU, Ph.D. in Dentistry, Tokyo University, Japan

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