Immediate loading implants: review of the critical aspects

Area of Science:

• Dentistry
• Oral Implantology
• Prosthodontics

Background:

• Modern dentistry is rapidly evolving, with implant-rehabilitation protocols being redefined to meet patient demands for improved comfort, aesthetics, and shorter treatment times.
• Immediate loading protocols aim to reduce treatment duration, enhancing patient satisfaction and clinical efficiency in dental implantology.

Purpose of the Study:

• To explore the concept of immediate implant loading (ILI) and its clinical practice indications.
• To critically evaluate factors influencing the outcomes of immediate implant loading procedures.

Main Methods:

• Classified three implant load timing protocols: immediate loading implants (ILI), early loading implants (ELI), and conventional loading implants (CLI).
• Considered micromovements and implant primary stability, assessed via insertion torque value, as critical for osseointegration.
• Highlighted the importance of evaluating bone density using computerized tomography (CT) for immediate loading success.

Main Results:

• Clinical success of immediate implant loading is contingent upon patient selection, bone quality/quantity, implant characteristics, primary stability, occlusal load, and surgical skill.
• Implant primary stability is identified as the most crucial factor for successful immediate loading outcomes.
• Immediate loading implants (ILI) demonstrate a higher risk of failure compared to conventional loading implants (CLI), though survival rates are generally high for both.

Conclusions:

• Successful outcomes with immediate implant loading (ILI) are achievable when established criteria, especially primary stability, are fulfilled.
• Despite a slightly increased risk, ILI offers a viable option with high survival rates when compared to conventional loading implants (CLI).
• Heterogeneity in study designs, surgical procedures, prostheses, and loading times limits definitive conclusions on ILI efficacy.