Present status of immediate loading of oral implants.

PROBLEM: Several conditions must be present to obtain implant integration and long-term clinical success when using the one-stage implant placement procedure with immediate loading. These conditions include (1) primary stability, (2) sufficient bone quality, and (3) elimination of micromovement of the implant before osseous integration is complete. PURPOSE: This report presents the results of research on immediate loading using a new and innovative implant design, Ankylos. METHODS: The author reviewed clinical studies of immediate loaading or oral implants, including two treatment options, removable overdentures and fixed reconstructions. RESULTS: Animal studies have demonstrated that successful osseointegration of Ankylos implants can occur (Figure 2D) when implants are placed and loaded immediately in the presence of some specific conditions. The histological findings involving implants that were placed in humans and immediately loaded showed no fibrous tissue formation (encapsulation). The bone-to-implant contact (osseointegration) was found to be excellent between the immediately-loaded implants and the surrounding alveolar bone. CONCLUSION: The Ankylos implant system with its progressive thread design successfully promotes primary, clinical stability at the time of implant placement. Several animal studies have shown that in implant restorations placed in similar areas of poor bone quality (ie, maxilla and the posterior part of the mandible), the concept of immediate loading can result in long-term clinical success, when loading forces are controlled. Immobilization of the implants and soft diet recommendations that reduce micromovement at the bone-to-implant interface will improve long-term clinical success. In summary, the Ankylos implant is well designed for one-stage placement with immediate loading, as well as for two-stage treatment protocols. Both clinical protocols will result in long-term clinical survival.