Immediate restoration and loading of dental implants: clinical considerations and protocols

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.