IMPLANTS AND TEETH IN ONE DAY
A very innovative system is the immediate loading, that has the big advantage of reducing to only one day the process of placing implants and teeth, as opposed to the 3 or 4 months that it would take with the more traditional methods.
According to conventional protocols, once an implant is placed, it is necessary to wait during 8 to 12 weeks to achieve integration with the bone and being able to place the prosthesis on the implants.
This treatment protocol is the most common, and it is the one we generally recommend when it is necessary to replace posterior teeth. We need to keep in mind that a dental implant is the least invasive technique to replace a lost tooth, as it avoids touching or damaging other healthy teeth, it will avoid teeth migrations to that empty space, restores proper chewing function and will provide a natural and aesthetic appearance.
CLINICAL CASES
But the new implant designs in terms of shapes and surfaces aim at reducing the treatment time and actually, if the case allows for it, they propose:
Immediate loading: placing the implant and the crown on the same day of the surgery, which entails considerable time savings for the patient and greater comfort.
We generally reserve this procedure for situations where aesthetics play a major role, teeth in the front of the mouth (anterior) for instance, as the patient will feel much more comfortable and self-confident if leaving the clinic already with a crown on the newly placed implant.
Another case may be the placing of two implants with the simultaneous placing of a bridge over both implants for better functionality and aesthetics, as the gum in these cases will adapt much better to implant and crown.
Another option is to place between four and six implants and to have, on the same day, a prosthesis fixed onto these implants. This system will favour an even distribution of forces which will foster proper osteointegration and greater comfort of the patient, as they will be going out with fixed teeth.
Another variation with the new techniques is the placing of immediate implants after the extraction of one or several teeth.
The ALL–ON–4 technique implies a revolution for patients who have got less bone volume and want to avoid more complicated interventions.
All on 4 is a simple surgical technique but a breakthrough approach that allows for totally toothless patients with little bone tissue, to have four implants placed and a fixed denture on them, all on the same day.
Another ground breaking possibility is computer guided surgery.
This is a procedure without flaps, whereby implants are placed through the gum, which makes it minimally invasive and reduces pain and inflammation to a minimum, thus achieving maximum patient comfort. The patient will leave the clinic already with their “third dentition” on.
The Nobel Guide system enables the preparation of a flapless surgery with exacting precision. It is possible to place implants and the dental prosthesis on the same day without having to open the gum or requiring stitches and sutures.
All these techniques require proper case assessment and programming to ensure that the quality and quantity of existing bone guarantee the primary stability of the implants.
The main advantage of these new techniques is that they reduce waiting time. Patients that have been wearing complete dental prosthesis appreciate this, as once they have made their mind on the treatment, they do not have to return to the clinic to replace their removable dentures with the fixed one, as they will leave the clinic with it already on. Chewing function will improve immediately. Also note that bone remineralisation is better around immediate loading implants and their success rate is equal to that of conventional treatments.