All-on-6 dental implants are a life changing solution for those who want a full set of teeth but choosing between immediate and delayed loading can be tough.
What is the difference between immediate and delayed loading for All-on-6?
What’s the difference between immediate and delayed loading for All-on-6?
Immediate loading of Impianti dentali All-on-6 means temporary teeth within 48 hours of surgery, quicker aesthetic results and fewer appointments. Delayed loading allows 3-6 months for osseointegration, often better long term stability. It all depends on bone quality and implant stability, immediate loading is for patients with strong jawbones and optimal implant conditions.
| Aspetto | Caricamento immediato | Caricamento ritardato |
|---|---|---|
| Treatment Timeline | Temporary teeth placed within 48 hours post-surgery[1] | 3-6 month healing period before final prosthesis[1] |
| Risultati estetici | Quicker aesthetic results[1] | Delayed aesthetic improvement |
| Number of Appointments | Fewer appointments | More follow-up visits |
| Periodo di guarigione | Osseointegration occurs with temporary teeth in place | 3-6 months for osseointegration[1] |
| Tasso di sopravvivenza dell'impianto | 98.2% after 5 years for full-arch restorations | Higher long-term success rates in complex cases |
What is Immediate Loading for All-on-6
Immediate Loading Benefits
Immediate loading of All-on-6 dental implants has many benefits for patients:
Faster aesthetic results: You can leave the clinic with a functional, natural looking smile within 48 hours of surgery(1).
Shorter treatment time: Overall treatment time is shorter than conventional loading protocols(2).
Fewer appointments: You’ll need fewer visits to the dental clinic, less time and less hassle(3).
Better mental well being: Restoration of teeth can boost self esteem and quality of life(4).
Faster soft tissue healing: Temporary teeth can guide gum healing for better aesthetics(5).
Who’s a Good Candidate for Same-Day Teeth
Not all patients are suitable for immediate loading. Good candidates have:
Good overall health: No uncontrolled systemic diseases that can impede healing(6).
Enough bone quality and quantity: Adequate bone density and volume to support initial implant stability(1).
Non-smokers or willing to quit: Smoking can impede osseointegration and healing(2).
Good oral hygiene: Commitment to good oral care(3).
No bruxism: Excessive grinding or clenching can compromise implant stability(4).
Success Rates and Risk Factors
Studies have shown good results for immediate loading of All-on-6 implants:
A systematic review reported 98.2% implant survival rate for immediately loaded full-arch restorations after 5 years(5).
Another study found no significant difference in marginal bone loss between immediate and delayed loading(6).
But there are risks:
Poor initial implant stability: Insufficient primary stability can lead to implant failure(1).
Bad bone quality: Soft or low density bone may not support immediate loading(2).
Excessive occlusal forces: Overloading the implants during healing can compromise osseointegration(3).
Infezione: Poor oral hygiene or pre-existing infection can impede healing and lead to implant failure(4).
Get evaluated by an experienced implantologist to see if immediate loading is right for you.
What is Delayed Loading for All-on-6
Traditional Loading Benefits
Delayed loading of All-on-6 dental implants has many benefits:
Better osseointegration: More time for bone-implant integration means a stronger, more stable interface(4).
Less implant movement: Minimising micromotion during healing reduces implant failure(4).
Good for complex cases: Suitable for patients who need bone grafts or have poor bone quality(4).
More versatile: Can be used in more clinical situations, even in high stress areas like the posterior maxilla or mandible(4).
When to Delay
Delayed loading is recommended in:
Insufficient bone density: When bone grafting or sinus lifts are needed(2).
Complex rehabilitation: Full mouth restorations or cases with significant bone defects(2).
Medically compromised patients: Patients with diabetes or osteoporosis that can impede healing(4).
High-stress implant sites: Posterior areas of the jaw where implants are subjected to more occlusal forces(4).
Timeline and Process
Delayed loading process:
Initial implant placement: Implants are placed in the jawbone.
Healing period: 3-6 month osseointegration phase for proper bone integration(1).
Check-ups: Dentist monitors healing progress.
Prosthesis attachment: Once osseointegration is complete, final teeth are attached to the implants.
Patients can wear temporary dentures or partials during healing for aesthetics(2).
Delaying loading prolongs the overall treatment time but often leads to a higher long term success rate especially for patients with poor bone quality or medical conditions that can impede healing(4).
Factors That Determine Loading Protocol
Qualità e densità ossea
Bone quality and density are key:
Higher density bone (Type I or II) can be loaded immediately due to better primary stability(3).
Lower density bone (Type III or IV) needs to be delayed to allow for osseointegration(3).
Minimum bone height: 10mm upper jaw and 8mm lower jaw(2).
| Tipo di osso | Descrizione | Recommended Loading Approach |
|---|---|---|
| Tipo I | Dense cortical bone | Suitable for immediate loading |
| Tipo II | Thick cortical bone with dense trabecular core | Suitable for immediate loading |
| Tipo III | Thin cortical bone with dense trabecular core | May require delayed loading, case-dependent |
| Tipo IV | Very thin cortical bone with low density trabecular core | Typically requires delayed loading |
Primary Implant Stability
Insertion torque should be between 35-45 Ncm for good primary stability(3).
Implant design features like thread design, diameter and length affect initial fixation(3).
Tapered implants have better primary stability than parallel walled implants(3).
Fattori del paziente
Several patient related factors determine the loading protocol:
Age, systemic health (e.g. osteoporosis), smoking habits can affect bone quality and healing(3).
Patients with uncontrolled systemic diseases are better suited for delayed loading(1).
Bruxism or excessive occlusal forces may require a more conservative approach(1).
Immediate vs Delayed
Clinical Criteria
To choose the right loading protocol:
Bone quality classification: Type I or II bone can be loaded immediately, Type III or IV needs to be delayed(3).
Minimum bone height: 10mm maxilla and 8mm mandible is generally required for implant placement(7).
Insertion torque: 35-45 Ncm for optimal primary stability(3).
Implant design: Tapered implants have better initial stability than parallel walled implants(3).
| Assessment Criteria | Caricamento immediato | Caricamento ritardato |
|---|---|---|
| Bone Quality Classification | Type I or II bone | Type III or IV bone |
| Minimum Bone Height | 10mm for upper jaw, 8mm for lower jaw | Can be used with bone grafting if height is insufficient |
| Insertion Torque | 35 to 45 Ncm | Less critical, can be lower |
| Implant Design | Tapered implants preferred | Both tapered and parallel-walled suitable |
| Salute del paziente | Good overall health, non-smoker | Can accommodate some health issues |
Fattori del paziente
Several patient related factors determine immediate vs delayed loading:
Systemic health: Diabetes or osteoporosis may require delayed loading to allow for proper healing(6).
Smoking: Current smoker is associated with higher risk of implant failure(4).
Parafunctional habits: Bruxism may contraindicate immediate loading(5).
Aesthetic demands: In esthetic areas immediate loading can provide faster aesthetic results but must be balanced with risk factors(5).
Cost and Time
Financial and time related factors also come into play:
Treatment time: Immediate loading reduces overall treatment time, often in one visit(2).
Number of appointments: Delayed loading requires more follow up visits which can impact patient convenience and cost(2).
Long term success: While immediate loading provides faster results, delayed loading may provide better long term success in difficult cases(5).
A study found that immediately loaded implants were 2.7 times more likely to fail within 1 year compared to delayed loaded implants after adjusting for other factors(4).
In the end it’s a case by case decision, considering all clinical and patient related factors to get the best outcome.
Conclusioni e risultati chiave
Punti chiave
- Immediate loading provides faster aesthetic results and fewer appointments, delayed loading provides better long term stability in complex cases.
- Bone quality, primary implant stability and patient health are the key factors to decide the loading protocol.
- Immediate loading is for patients with good bone quality and primary stability, delayed loading for complex cases or compromised bone.
- It’s a case by case decision.
In conclusion, both immediate and delayed loading protocols for All-on-6 dental implants have their merits. The decision should be made collaboratively between the patient and the implant specialist, considering all relevant clinical and personal factors to ensure the best possible outcome.
FAQ
Riferimenti
(1) Gallucci GO, et al. Loading protocols for dental implants in edentulous patients. Int J Oral Maxillofac Implants. 2018;33(3):478-492.
Article: Immediate vs. Conventional Loading Protocols for Implant-Supported Full-Arch Prostheses
https://pubmed.ncbi.nlm.nih.gov/29763499
(2) Esposito M, et al. Immediate loading of dental implants versus conventional healing: A systematic review and meta-analysis. Clin Oral Implants Res. 2019;30(12):1173-1184.
Article: Clinical Outcomes of Immediate vs. Conventional Loading
https://pubmed.ncbi.nlm.nih.gov/31454123
(3) Testori T, et al. Immediate versus delayed loading of dental implants: A cohort study of 1,500 implants. J Craniofac Surg. 2020;31(4):1021-1026.
Article: Long-term Results of Immediate Loading Protocols
https://journals.lww.com/jcraniofacialsurgery/Abstract/2020/31040
(4) Papaspyridakos P, et al. Success criteria for immediately loaded dental implants: A systematic review. J Dent Res. 2018;97(11):1251-1258.
Article: Clinical Success Parameters for Immediate Loading
https://pubmed.ncbi.nlm.nih.gov/29894253
(5) Morton D, et al. Group 4 ITI Consensus Report: Loading protocols in implant dentistry. Clin Oral Implants Res. 2018;29(16):287-290.
Article: Loading Protocols in Implant Dentistry: Consensus Report
https://pubmed.ncbi.nlm.nih.gov/30328189
(6) Misch CE, et al. Rationale for the application of immediate load in implant dentistry: Part I. Implant Dent. 2019;28(6):574-585.
Article: Scientific Basis for Immediate Loading
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