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A New Protocol for Immediate Functional Loading of Dental Implants By Thomas J. Balshi, DDS, FACP; Background The idea of immediate functional loading of dental implants is not a new one. By the late 1800s, dentists on both sides of the Atlantic were experimenting with numerous designs and materials for early implant prototypes, many of which were immediately loaded, and some of which survived for protracted periods2. Failure was also widespread, however, due at least in part to the lack of scientific data to support these early efforts. Brånemark's work forever changed the landscape of implantology. His scientific research and subsequent clinical studies in the Department of Anatomy at Gothenburg University led him to conclude that a number of elements were crucial to achieving long-term survival of endosseous implants. As little trauma as possible should be inflicted upon the bone at the implant-receptor site, Brånemark believed, and osteotomies should be created in which the implants fit snugly rather than adjoining any voids. Brånemark also believed that, once placed, implants needed to be protected from motion that might loosen them and cause the formation of fibrous encapsulation. Such encapsulation would interfere with the in-growth of bone into the implants' titanium surface, a phenomenon for which Brånemark coined the term "osseointegration." Since then, no one has cast any doubt upon the efficacy of Brånemark's two-stage implant-placement protocol as a means of ensuring osseointegration. What has happened, however, is that a number of researchers (including Brånemark himself3) have turned their attention to the question of whether osseointegration might also be achievable in the wake of immediate loading. In the late 1970s, Ledermann4 began placing titanium-plasma-sprayed implants and the same day splinting and immediately loading them with mandibular overdentures. In 1984, he reported a 91.2 percent survival rate for 476 implants placed in 138 patients5. Schroeder et al (in 1983)6 and Babbush et al (in 1986)7, following the same protocol, reported success rates of 98.1% and 96.1%, respectively. Since then well over a dozen other studies have demonstrated the effectiveness of immediate loading of endosseous implants8-23. |
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All information is intended for your general knowledge only and is not a substitute for dental or medical advice or treatment for specific dental or medical conditions. You should seek prompt dental and medical care for any specific health issues. See Disclaimer Copyright 2009 Pi Dental Center (Prosthodontics Intermedica). |
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