Early Intraoral Splinting and Loading of One-Stage Dental Implants in the Edentulous Mandible: Literature Review and Case Report

Early Intraoral Splinting and Loading of One-Stage Dental Implants in the Edentulous Mandible: Literature Review and Case Report
March 2003
Hartman, Gary A. DDS, MS***
Implant Dentistry: Volume 12(1) March 2003 p 9
Lippincott Williams & Wilkins
Section Editor(s): Cagna, David R. DMD*; Dyer, Scott R. DMD**; Hartman, Gary A. DDS, MS***; Loughlin, Robert M. DDSÇƒÜ; Mills, Michael P. DMD, MSÇƒ?; Oates, Thomas W. Jr., DDS, PhD¨?
Department of Periodontics
University of Texas Health Science Center at San Antonio
7703 Floyd Curl Drive
San Antonio, TX 78284-7894
Editors' Note:
Dear Reader, please be aware that articles reviewed in this segment of the Journal are selected by the Editors and are assigned to be reviewed by knowledgeable individuals. These are not fillers. Each article has been carefully analyzed and diligently reviewed.
Early Intraoral Splinting and Loading of One-Stage Dental Implants in the Edentulous Mandible: Literature Review and Case Report
P. Exbrayant, Pract Proced Aesthet Dent, 2002;1:529-536
A tremendous amount of research in recent years has been geared toward shortening treatment times and improving patient satisfaction with implant therapy. Advances in implant surface characteristics, thread design, and a better understanding of the biologic principles of osseointegration has led to a significant decrease in the postsurgical healing period. The concept of immediate loading of implants has enabled clinicians to provide patients with an implant-supported, functioning dentition in days rather than months.
This article presents a comprehensive literature review of the reports focusing on the immediate loading of implants in the edentulous mandible. A case report is also presented that illustrates a slightly different prosthetic approach that may save chair and lab time. The author claims that reports investigating the immediate loading of implants in the edentulous mandible have shown similar success rates to the traditional, delayed-loading approach. This high success rate can be attributed to the quality of bone typically found in the anterior mandible, the surface design of the implant, and the rigid splinting of the implant fixtures as they are incorporated into the prosthetic design. Four tables are presented that summarize the literature on the similarity in success rates of one- versus two-stage implants and immediate versus delayed loading protocols.
The case report presented is that of a patient with a hopeless mandibular dentition in which the teeth were extracted, implants placed, and immediately loaded with a bar-clip assembly overdenture. The author reports on an intraoral approach to fabricating the bar assembly and claims that this type of intraoral assembly of the bar pattern can significantly reduce chair time and increase patient satisfaction during the fabrication of an immediate prosthesis. While only short-term results are available, this case report demonstrates the effectiveness of eliminating an extensive healing period as well as a new method of obtaining a bar pattern for the prosthesis.
¨© 2003 Lippincott Williams & Wilkins, Inc.