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A New Protocol for Immediate Functional Loading of Dental Implants

By Thomas J. Balshi, DDS, FACP
and Glenn J. Wolfinger, DMD, FACP

Indications for Teeth in a DayTM

Not every patient or every tooth site is indicated for the Teeth in a DayTM approach. Patients must understand the limitations of such treatment and be willing to accept the scientifically based precautionary measures. Chief among them is the fact that in order to limit the functional forces during osseointegration, patients need to abstain from chewing anything but soft food or otherwise applying force to the restoration for approximately three months. Because of this need, the author considers severe bruxism currently to be a contraindication for the Teeth in a DayTM protocol. However, judicious use of additional implants may enable mild or moderate bruxers to be considered candidates for immediate loading.

Although immediate functional loading can be employed for single-tooth replacement, partial edentulism, and full edentulism, the Teeth in a DayTM protocol is generally contraindicated for single posterior teeth, especially molars. A posterior tooth may be subjected to three to four times the occlusal forces of an anterior one. Moreover, the esthetic deficit of living with a missing posterior tooth is usually significantly less than it would be for anterior dentition.

Similarly, when a patient has worn a removable denture for many years or when natural tooth abutments can be saved and used to support a provisional restoration, immediate loading may not be as critical as for the patient who faces the prospect of going directly from natural teeth to dental implants. For the latter, immediate loading is an excellent option for transitioning the patient.

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