Immediate restoration and loading of dental implants: clinical considerations and protocols. – The International Journal of Oral & Maxillofacial Implants

ABSTRACT: The use of dental implants to assist in the treatment of partial and complete edentulism is well documented. Most of the implant literature, however, reports results associated with implant survival and success when there has been adherence to rigid placement and loading protocols. Conventionally, these protocols call for the undisturbed healing of the implant-3 months in the mandible and 4 to 6 months in the maxilla. This article evaluates the literature and develops protocols for clinical procedures for the early or immediate restoration or loading of dental implants. Criteria are established for defining immediate loading, immediate restoration, early loading, and early restoration as compared to conventional protocols. The review assesses factors that influence accelerated loading and restoration decisions, including bone quality and quantity, implant design, splinting of implants, and prosthetic design. Conclusions and recommendations are made based on the experience of the consensus group charged with considering these procedures and on the current literature published on these protocols.

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OnFebruary 12, 2015, posted in: Latest News by

Rehabilitating the Failing Dentition: Full-Arch Immediate Placement, Immediate Load Therapy – Functional Esthetics & Restorative Dentistry

ABSTRACT: Implants have become an important component of the dental armamentarium. Implants have customarily been installed and remained unloaded for a period of time in order to promote bone attachment to the surface.Multiple surgeries and provisionals were required, resulting in additional treatment time and costs. More recently, however, full-arch immediate placement, immediate load therapy has presented a new alternative. Eliminating the problems associated with serial extractions and full dentures, immediate loading also has the added benefit of allowing the patient to go from a failing dentition to a repaired one within 48 hours. The purpose of this article is to establish a rationale and protocol for rehabilitating the failing dentition utilizing an immediate load approach.

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OnFebruary 12, 2015, posted in: Latest News by

The Radiographic Bone Loss Pattern Adjacent to Immediately Placed, Immediately Loaded Implants – The International Journal of Oral & Maxillofacial Implants


The purpose of this study was to evaluate radiographic bone levels adjacent to implants placed in fresh extraction sockets (ESs) and immediately loaded with a fixed full-arch provisional restoration compared to bone levels adjacent to implants placed in native bone (NB) under the same restorative conditions.

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OnFebruary 12, 2015, posted in: Latest News by

Immediate Teeth on Dental Implants

itiUsually when dental implants are placed into the bone, it is necessary for them to heal (osseointegrated) for six to twelve weeks before teeth can be made to go on top of them. One method of replacing the tooth or teeth during the healing period is through a removable prosthesis. Unfortunately, this can cause a disruption of lifestyle for many people. Over the last seven years, our practice has utilized a technique where temporary teeth are attached directly to the implants immediately after the surgery while still allowing the implants to heal in an undisturbed manner. This technique allows the patient to resume close to normal activity while providing immediate esthetic and functional results.

Immediate Temporization on Implants (ITI) Dental Implants have become a widely accepted and predictable mode of treatment for many patients. One of the limiting factors in the past of performing implant dentistry was the delay in receiving a fixed prosthesis due to the healing time necessary for implants to osseointegrate.

In turn, patients were asked to wear a removable prosthesis that was many times ill fitting due to the need for relieving it under the implants to prevent trauma during the healing. Some patients were asked not to wear anything for 1 to 3 weeks following implant surgery. Other patients who were able to maintain a fixed temporary bridge had problems associated with frequent loosening of the bridge and tooth related complications. These shortcomings prevented many restorative dentists and patients from accepting implants as a potential mode of therapy. In the last five years, our practice has been placing dental implants and then having you, the restorative dentist, place a fixed temporary prosthesis onto the implants the same day of surgery. This technique has eliminated the grief associated with situations described above. As a result, patients are more accepting of the desired treatment plan, the treatment steps are fewer and less complicated and the implants osseointegrated quicker and stronger.



At the time that our paper was published in May 2000 Journal of Periodontology, we had reported on 149 implants and 27 cases with a success rate of >95%. This was the largest sample of documented patients with immediate temporization on implants in the world. As of today, we have over 1,500 implants and 150 cases with a success rate >96%. Below is a list of references that discuss the technique and rationale.


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OnJuly 15, 2012, posted in: Latest News by

Dental Implants May Offer Smokers an Advantage – The International Journal of Oral & Maxillofacial Implants

It has been shown in the dental and medical literature that patients who smoke have greater incidence of periodontal disease, root decay and an overall reduced healing response. This puts smokers into the high risk group for developing dental diseases. Previously, it had been demonstrated that even dental implants had a higher failure rate in smokers than in than non smokers. However, these studies were performed utilizing a specific type of implant surface. Over the last eight to ten years, there has been a great deal of research conducted on newer implant surfaces. These surfaces have led to higher success rates and improved healing. Our practice published a landmark study that showed that smokers healed as well as and with a similar success rate with regard to implant treatment as non-smokes. These results are very promising for patients who smoke because now there may be an alternative therapy that can offer excellent success.

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OnMarch 8, 2012, posted in: Latest News by

Improved Quality of Life for Denture Wearers

Many patients who wear dentures rely on the use of adhesive materials to help secure their loose fitting prosthesis. This can cause great difficulty while chewing certain foods and create embarrassing situations where the denture loosens during speech. Dental implants can help denture wearers in two ways:

  1. If there is sufficient bone available, enough implants can be placed to help support a permanent (non-removable) bridge replicating a natural set of teeth.
  2. A more cost effective method is to place two implants to help retain their existing denture. The implants provide excellent retention eliminating the need for denture glue.

In addition, the cases, patients who wear full upper dentures can have four implants placed. This not only allows for excellent retention but can also eliminate the palate portion of the denture. This greatly reduces the gag reflex and allows for patients to better taste foods and differentiate between hot and cold.


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OnJanuary 8, 2012, posted in: Latest News by