Intra-oral welding of implants for an immediate load with overdentures

Different clinical applications of the Hruska intra-oral welding machine have been described in previous articles (Hruska, 1986, 1987, 1988, 1989a,b). These applications were related to over 100 cases of the use of non-submergible implants. This paper will describe a revised application of this machine as used with the currently popular multiform submergible implants widely used in the United States. The intra-oral welding is performed immediately after suture placement, with one or more connecting titanium wires serving as the splinting medium. This permits the patient to leave the office with a stable and retentive overdenture resting securely on the newly created splint performed the same day of surgery. This avoids the potentially troublesome problem of allowing the overdenture to be supported by the recently altered soft tissues. In addition, the patient otherwise would not have the use of a denture during the bone-healing period, which creates an alteration in psychological as well as physiological status. The disadvantages of immediate loading are counteracted by the splinting and load-sharing. This encourages the bone around the implants to reorganize and remodel according to Wolff's law, as demonstrated by De Angelis (1970) and Dalin and Olsson (1974). Different studies (Sutter et al., 1983a,b; Schroeder, 1985; Jennings, 1991) have shown that the ankylotic connection between one-stage titanium ITI implants and bone (so-called osseointegration) occurs and is maintained under load.