Immediate Load Dental Implants

What are immediate load dental implants? Who is a candidate?

  • Immediate load dental implants allow posts to be placed in the bone and the new "teeth" to be placed immediately.
  • Instead of having to make multiple appointments weeks apart, immediate load dental implants can be done in one visit.
  • Candidates for immediate load dental implants include those who are having full arch implants, single or multiple teeth in the front of the mouth, and those who have dense bone.
  • Dr. Scharf can tell you if you are a good candidate for immediate load dental implants.

Immediate load dental implants represent an incredible advance in implant dentistry. The advantage of immediate load implants is that you don't have to wear a removable temporary tooth replacement while the implants are bonding with the bone.

When implant technology was first introduced, the protocol for placing dental implants was to place the implant and wait for a period of 3–6 months before making the crown or "loading" the implant. It was thought at the time that the implant must be unloaded in order for it to bond with the bone.

More recent research has shown that under the right conditions, implants can be loaded right away and achieve the same high rate of success as unloaded dental implants. We now know for a fact that it is not the load on the implant that determines whether or not it will bond with the bone but rather the degree of "micromotion" of the implant within the bone.

Bone is not as rigid as most people think; it is actually somewhat elastic. This means that an implant can move very slightly within the bone. This "micromotion" must be under 100 microns for the implant to bond properly to the bone. The initial stability of the implant (how secure, or "tight," it is in the bone) will determine how much force can be applied to the implant while keeping the amount of micromotion under the critical threshold.

Think of the implant like a beach umbrella in the sand. If you dig a hole and stick the umbrella pole into the hole, the umbrella will be stable but will still move a little, like the micromotion of a dental implant set in bone. This stability can be affected by several factors.

The longer the pole and the deeper it is set in the sand, the less the umbrella will move. If the umbrella is placed in cement, the amount of movement will be much less than if the umbrella is placed in loose sand. If the breeze is gentle, the umbrella will not move much. If the winds are very strong, the umbrella will move more and may even blow away. If the wind is blowing straight down, the umbrella will move less than if the wind is blowing violently from side to side. The type of beach umbrella pole can even affect how stable it is, as some poles are designed to grip the sand better than others.

A dental implant will be more stable if set securely and able to grip onto the bone. It needs to be able to withstand downward biting pressure as well as the side-to-side grinding pressure of chewing. When evaluating a patient to see if he or she is a good candidate for immediate load implants, Dr. Scharf will consider a number of factors:

  • Like the umbrella pole, the depth of placement is important. A longer implant is better than a shorter one, and the deeper it can be set, the more stable it will be. The more bone there is to stabilize the implant, the less micromotion will occur.
  • Dense bone is best. If the bone is not dense, it will not hold the implant as securely—like an umbrella set in sand versus one set in cement.
  • The less force there is on the implants, the better. Teeth in the front of the mouth have less force placed on them than teeth in the back of the mouth. Like the umbrella in a light breeze versus a strong wind, the less pressure, the less motion will occur.
  • The direction and amount of force are also important. The front teeth mainly have biting pressure (like wind blowing straight down on top of the umbrella). Back teeth have the additional sideways pressure from chewing (which is like rocking the umbrella around and around in its hole in the sand).

Likewise, a full arch of implants immediately loaded together can be very stable. When a number of implants arranged in an arch form are connected together with a stable bridge, all the force applied is spread out along the row of implants.

Immediate load dental implants can allow patients who are facing major extractions to walk out of the dental office sporting a full smile! Dr. Scharf has the skill, training, and experience to know if your case is a good candidate for immediate load implants.

The Procedure

Patients considering dental implants will have a dentascan taken by an i-CAT scanner. This will give Dr. Scharf a clear picture of how much bone is available and how dense it is. Dr. Scharf will then analyze your bite to determine if the forces are conducive to successful immediate load dental implants.

At the time of implant placement, Dr. Scharf will employ a number of advanced strategies to maximize your success. Some implant designs are better suited to the immediate load process than others. Dr. Scharf places implants designed by many different companies and will choose an implant design based on your particular situation. By not being locked into just one company, Dr. Scharf can choose the implant that will give the best initial stability for your unique needs.

When preparing the site for implant placement, Dr. Scharf will measure the density of the bone and plan accordingly. By "underpreparing" less dense bone and "overpreparing" very dense bone, Dr. Scharf can achieve the proper initial stability for your immediate load implant. (This ability to correctly gauge and compensate for bone density comes with years of experience and thousands of implants placed. Dr. Scharf is extremely skilled with immediate load dental implants, unlike many practitioners who are new to the method and use their patients as "guinea pigs" to learn the process.)

After the implant is placed, Dr. Scharf uses a special gauge to measure how tight the implant is in the bone. By measuring this "initial stability," he can accurately confirm the success of your immediate load implant.

Once the implant is placed, it is time to create the temporary teeth on top. This can be done by either Dr. Scharf or your personal dentist. This will all be worked out in advance so that before any treatment begins, you will know who is performing each stage of the procedure. The treatment will be carefully coordinated by Dr. Scharf and his staff.

Dr. Scharf has the skill and expertise needed to evaluate your individual needs and help you determine if immediate load implants are right for you. He has been placing dental implants since 1988, and in 2007, he was invited to lecture in Korea on the topic of immediate load dental implants. Today, Dr. Scharf is a recognized expert in the field of immediate load dental implants.