Immediate loading in implant dentistry: surgical, prosthetic, occlusal and laboratory aspects

  • V. Jiménez-López
UK: Quintessence price £125, pp 278 ISBN 848987333X | ISBN: 8-489-87333-X

With the rapid progression of implant techniques, immediate implant loading is at the cutting edge of where we are taking our patients. Shortening the time between implant placement and loading the implant is taking osseointegration to new frontiers.

This book sets out rules to explain the considerations for immediate loading, stressing the need for advanced knowledge in implant dentistry. It deals with the many immediate loading options, from single maxillary or mandibular incisor implant placement, to complete maxillary rehabilitation. These are discussed and followed up with various case studies.

Surgical techniques for immediate loading of single teeth are discussed in detail, ranging from those sites with adequate height and width of bone — to the more difficult cases following tooth extraction and loss of labial bone. Many interesting and thought-provoking cases are described, for example using two implants to mimic the root of a molar tooth to give more stability. Several factors are discussed when considering immediate loading of hybrid prostheses in the mandible, including the idea of placing more implants. Countersinking is not recommended, as the implant needs to be embedded in cortical bone. All treatments described are supported by excellent photographs, which make the book user-friendly.

Chapter five deals with implant loading with overdentures and mandibular hybrid prosthesis. Fixed hybrid prostheses are explained extensively, from the making of the surgical stent impressions and bite registration to the final screw retained prostheses. Again, all the stages are well illustrated photographically.

The author also describes the Brånemark Novum surgical and prosthetic procedure for mandibular immediate loading. Although the Brånemark Novum procedure is time efficient, the technique is complex and should only be carried out by experienced implantologists.

Immediate implant loading in patients with completely edentulous maxilla is detailed, and the importance of patient selection and clinical evaluation. Patients must be in good health and there should be sufficient bone to place at least six implants of 10 mm or greater in length.

The author warns that although immediate loading in the maxilla has advantages, there are greater demands on the surgeon and technician. Laboratory solutions are considered to achieve the final goal of a passive fit. The procedures range from the design of the alloy structure and selection of the recovering material to milled procera prosthesis. Screw-retained superstructures and infrastructures are also covered.

I found the final chapter very useful in dealing with the occlusal aspects of immediate loading. Occlusion in single tooth replacement and complete maxillary mandibular fixed rehabilitation are discussed and the use of night guards recommended. I would highly recommend this book for your implant library.