Extractions, Implant Placement, and Immediate Loading of Mandibular Implants: A Case Report of a Functional Fixed Prosthesis in 5 Hours

Extractions, Implant Placement, and Immediate Loading of Mandibular Implants: A Case Report of a Functional Fixed Prosthesis in 5 Hours
December 2003
Petropoulos, Vicki C. DMD, MS*; Balshi, Thomas J. DDSÇƒÜ; Balshi, Stephen F. BBEÇƒ?; Wolfinger, Glenn J. DMD¨?
Implant Dentistry: Volume 12(4) December 2003 pp 283-290
Lippincott Williams & Wilkins
*Assistant Professor of Restorative Dentistry, Department of Restorative Dentistry, University of Pennsylvania School of Dental Medicine, Consultant Prosthodontist Veterans Affairs Medical Center, Philadelphia, Pennsylvania.
ÇƒÜProsthodontics Intermedica, Institute for Facial Esthetics, Washington, Pennsylvania.
Çƒ?Postgraduate student, Drexel University, School of Biomedical Engineering and Science, Philadelphia, Pennsylvania.
¨?Prosthodontics Intermedica, Institute for Facial Esthetics, Fort Washington, Pennsylvania; Staff Prosthodontist Veterans Affairs Medical Center, Philadelphia, Pennsylvania; and Lecturer, Department of Prosthodontics, Columbia University School of Dental and Oral Surgery, New York, New York.
Reprint requests and correspondence to:
Vicki C. Petropoulos, DMD, MS
University of Pennsylvania School of Dental Medicine
4001 Spruce Street
Department of Restorative Dentistry
Philadelphia, PA 19104-6003
Phone: (215) 898-8980
Fax: (215) 573-9606
E-mail: VPetropoulos@aol.com
Abstract
The purpose of this report is to present a reliable surgical and prosthodontic protocol for immediate loading of implants, allowing patients to receive a fixed implant-supported prosthesis in a matter of hours. The surgical, prosthodontic, and laboratory steps for this protocol of immediate functionally loading the implants are described for the treatment of a 51-year-old woman who presented with a hopeless mandibular dentition and an edentulous maxillary arch. It is possible to decrease the treatment time in successfully restoring the patient's oral function by means of immediate functional loading of dental implants and immediately placing a fixed implant-supported prosthesis. Compared with the traditional implant protocols, this protocol of a one-visit approach for patient treatment 1) decreases the number of office visits; 2) decreases the treatment time; 3) reduces the patients' costs; 4) allows the patient to avoid wearing a removable interim prosthesis; and 5) increases the patients' acceptance of treatment while maintaining predictability in treating mandibular edentulism.
It is clinically recognized that osseointegrated dental implants, following traditional protocols, provide the dental profession with a predictably successful method of solving problems related to complete and partial edentulism. 1 There are, however, many dental professionals and large patient populations who are reluctant to accept the validity and success this treatment offers. 2 Dental professionals and patients often think that implant treatment is too costly, too time-consuming, and too painful with long periods of using uncomfortable interim prostheses. 2 Many patients are under the impression that they will be without teeth for extended lengths of time. This factor has a tremendous psychologic and social impact on patient acceptance of implant treatment.
The profession has sought to reduce the treatment time for dental implant rehabilitation by shortening the healing time using the following approaches: 1) early loading of implants 3-5; 2) immediate loading of implants 6-10; 3) developing implant surfaces intended to accelerate the osseointegration process 11,12; 4) immediately placing the implants into the tooth extractions sites 13-17; and 5) developing the Br?ïnemark Novum System (Nobel Biocare, Yorba Linda, CA) for the fabrication of a final, fixed prosthesis. 18 All of these methodologies reflect a desire not only to reduce treatment time, but also to increase patient acceptance.
Unlike traditional osseointegrated implant therapy, which could take 1 to 2 years from the initiation of treatment to completion of the final prosthesis, the expedited patient care (Teeth in a Day) protocol 19 reduces treatment time and increases patient acceptance by providing fixed rehabilitation in one treatment visit in a matter of 5 hours. The protocol demonstrated in the following patient treatment report is based on the successful research for immediate loading of Br?ïnemark implants, which has been published in the dental literature. 20,21 The results of implant survival following the expedited patient care protocol has been equivalent to the survival rates for patients treated with traditional submerged healing times of 3 to 6 months for Br?ïnemark implants in the mandible and maxilla, respectively. 22
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