The terms
"Loading" means attaching a tooth, bridge or denture to an implant.1 A Cochrane review (2013) uses three timing groups.1
| Protocol | Timing after implant surgery |
|---|---|
| Immediate loading | Within 1 week |
| Early loading | 1 week to 2 months |
| Conventional (staged) loading | After 2 months |
The ADA states that some patients can have implants and replacement teeth placed in one visit.2
Why healing time was the default
Implants were traditionally kept free of load for 3 to 8 months to allow the bone to bond to the implant.1 AAOMS states that full osseointegration can take up to a few months.3
What the trials show
The Cochrane review analyzed 26 randomized trials with 1,217 participants and 2,120 implants.1
- Mean implant failure across all trials was 2.5 percent in the first year.1
- Comparing immediate with conventional loading, there was no evidence of a difference in prosthesis failure or implant failure in the first year.1
- Immediate loading showed slightly less bone loss (0.10 mm), a difference the authors said may not be clinically important.1
The review concluded there was no convincing evidence of a clinically important difference between loading times, and called for more well-designed trials.1
Two kinds of same-day teeth
AAOMS separates two options.3
- Immediate provisionalization. A temporary crown placed for appearance only, not for chewing.3
- Immediate loading. A temporary or permanent crown placed at surgery or shortly after, for patients with adequate bone.3
Who qualifies
AAOMS states immediate loading is available for patients with adequate bone.3 The All-on-4 consensus requires implant insertion torque over 35 Ncm (a measure of how firmly the implant is held at placement) before immediate loading.4 The ITI Group 2 consensus (2018) recommends planning the placement protocol and the loading protocol together.5
General information about dental implants. Treatment decisions are made with a licensed dentist.
Sources
- Esposito M et al. Different times for loading dental implants. Cochrane Database Syst Rev 2013. pubmed.ncbi.nlm.nih.gov
- American Dental Association (MouthHealthy): Implants. mouthhealthy.org
- AAOMS (MyOMS.org): How Do Dental Implants Work?. myoms.org
- Penarrocha-Diago M et al. Consensus statements on All-On-4 standard treatment. J Clin Exp Dent 2017. pubmed.ncbi.nlm.nih.gov
- Morton D et al. Group 2 ITI Consensus Report: Prosthodontics and implant dentistry. Clin Oral Implants Res 2018. pubmed.ncbi.nlm.nih.gov
