Diagnosis and Planning in Immediate Loading: Prosthetic Diagnosis

Abstract

Immediate loading provides functional and esthetic advantages, improving the quality of life of the patient during the osseointegration period. But, clinicians have to know that the three key parameters that should be evaluated for prosthetic planning of the totally edentulous patient are prosthetic space, lip support, and smile line. This is a crucial part of the planning because the prosthetic space, lip support, and smile line determine the type of prosthetic restoration.

The diagnosis and planning in immediate loading are composed of three phases. The clinician must be careful and the case is not made without previous diagnosis and planning. In the first planning phase, dentists have to examine extraoral and intraoral images and initial radiological diagnosis through panoramic radiographic and study models. The second planning phase consists in transference and analysis of models, diagnostic wax-up, and diagnostic-radiological splint. The third planning phase needs a specific radiographic exploration by means of three-dimensional radiology being done. This phase of radiographic evaluation should include a prosthetic reference or guide that allows relating the alveolar process axis with the ideal prosthetic axis. And the fourth planning phase consists in choosing the type of prosthesis and kind of prosthetic abutments to be used in immediate loading. This will allow to prepare a personalized budget as well as a treatment plan with the temporal sequence and informed consent for the patient.