Workshop guidelines on immediate loading in implant dentistry

Carl E. Misch, Jack Hahn, Kenneth W. Judy, Jack E. Lemons, Leonard I. Linkow, Jamie L. Lozada, Edward Mills, Craig M. Misch, Henry Salama, Mohamed M.H. Sharawy, Tiziano Testori, Hom Lay Wang

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

The delivery of care for patients missing 1 or all of their teeth very often requires implants to restore function, esthetics, bone and softtissue contours, speech, and intraoral health. The delayed occlusal loading protocol, either the 1- or 2-stage approach, has been evaluated for more than 30 years by a number of clinical settings and situations. However, in some patient conditions, the delayed-healing process can cause physchologic, social, speech, or function problems. A full range of treatment options relative to the initial hard- and soft-tissue healing is available. Immediate restoration of a patient after implant surgery is one of these alternatives. A benefit-risk ratio may be assessed for each patient condition to ascertain whether immediate occlusal loading is a worthwhile alternative. The greater the benefit or the lower the risk, the more likely immediate loading is considered. A complete edentulous mandible restored with an overdenture supported by 4 or more implants is a very low-risk condition. If the patient cannot tolerate a mandibular denture and does not wear the device, an immediate loading protocol would be highly beneficial. The highest risk for immediate loading would be a posterior single- tooth implant. Implant number cannot be increased, and implant length cannot engage cortical bone. When the singletooth replacement is out of the esthetic zone, very low benefit is obtained with the immediate restoration approach. In patients who are partially edentulous, immediate restoration does not necessarily mean immediate occlusal loading. A nonfunctional transitional device is less likely to cause occlusal overload during the initial bonehealing response. Whether or not the restoration is in function is not the most critical factor. Minimal micromotion at the implantto- bone interfacial zone during bone healing, however accomplished, appears to be a key factor. The traditional 2-stage approach to implant restorations have been evaluated for almost 3 decades. The immediate occulsal load approach, in comparison, is relatively new and has far less research and documented studies. Therefore, the staged approach to implant restoration should always be the first approach. This is especially noteworthy for the less-experienced practitioner. Immediate restoration does not necessarily mean immediate loading at the higher magnitude forces and cycles. Conservative approaches to reduce stress to the prostheses should lead to enhanced outcomes. Additional clinical studies to evaluate the associated risks, especially in the maxillary arch, are expected over the next several years. Until the profession has longer-term evidence and more multicenter studies, immediate occlusal loading will be a secondary treatment option, restricted on a case-by-case basis.

Original languageEnglish (US)
Pages (from-to)283-288
Number of pages6
JournalJournal of Oral Implantology
Volume30
Issue number5
DOIs
StatePublished - Oct 1 2004
Externally publishedYes

Fingerprint

Dentistry
Guidelines
Education
Esthetics
Bone and Bones
Single-Tooth Dental Implants
Overlay Denture
Equipment and Supplies
Dentures
Mandible
Multicenter Studies
Prostheses and Implants
Patient Care
Tooth
Odds Ratio
Health
Therapeutics
Research

ASJC Scopus subject areas

  • Oral Surgery

Cite this

Misch, C. E., Hahn, J., Judy, K. W., Lemons, J. E., Linkow, L. I., Lozada, J. L., ... Wang, H. L. (2004). Workshop guidelines on immediate loading in implant dentistry. Journal of Oral Implantology, 30(5), 283-288. https://doi.org/10.1563/0722.1

Workshop guidelines on immediate loading in implant dentistry. / Misch, Carl E.; Hahn, Jack; Judy, Kenneth W.; Lemons, Jack E.; Linkow, Leonard I.; Lozada, Jamie L.; Mills, Edward; Misch, Craig M.; Salama, Henry; Sharawy, Mohamed M.H.; Testori, Tiziano; Wang, Hom Lay.

In: Journal of Oral Implantology, Vol. 30, No. 5, 01.10.2004, p. 283-288.

Research output: Contribution to journalArticle

Misch, CE, Hahn, J, Judy, KW, Lemons, JE, Linkow, LI, Lozada, JL, Mills, E, Misch, CM, Salama, H, Sharawy, MMH, Testori, T & Wang, HL 2004, 'Workshop guidelines on immediate loading in implant dentistry', Journal of Oral Implantology, vol. 30, no. 5, pp. 283-288. https://doi.org/10.1563/0722.1
Misch CE, Hahn J, Judy KW, Lemons JE, Linkow LI, Lozada JL et al. Workshop guidelines on immediate loading in implant dentistry. Journal of Oral Implantology. 2004 Oct 1;30(5):283-288. https://doi.org/10.1563/0722.1
Misch, Carl E. ; Hahn, Jack ; Judy, Kenneth W. ; Lemons, Jack E. ; Linkow, Leonard I. ; Lozada, Jamie L. ; Mills, Edward ; Misch, Craig M. ; Salama, Henry ; Sharawy, Mohamed M.H. ; Testori, Tiziano ; Wang, Hom Lay. / Workshop guidelines on immediate loading in implant dentistry. In: Journal of Oral Implantology. 2004 ; Vol. 30, No. 5. pp. 283-288.
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