Immediate Loading with Fixed Full-Arch Prosthesis in the Edentulous Patient: Treatment Protocol

Abstract

Immediate loading is basically a prosthetic concept. However, the surgical implantological planning is very important to ensure a primary stability in the total edentulous patient. This characteristic is crucial to allow immediate loading in this type of patients. For the first time, the incisional design has allowed the clinician to overview about the surgical side. Later, maybe, the bone will need an osteoplasty to regularize possible bone defects. To ensure primary stability, it can use methods to enhance primary stability as undersized drilling technique and use of osteotomes and bi-cortical anchorage implants. There are two main protocols to obtain temporary immediate loading full-arch prosthesis, the chairside or direct technique, in which a conventional denture is adapted immediately after placing the implants, and the laboratory or indirect technique, in which impressions and bite registrations are obtained after implant placement and the laboratory fabricates the immediate loading prosthesis within several days. New devices specifically designed for immediate loading and digital technologies will facilitate and make more predictable treatment option. These new methods are Flexafit® (system of abutments with a pressure or friction fitting to retain implant-supported prostheses) and PIC Camera (new digital technique based on stereophotogrammetry).