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Loading Strategies

  • Mélanie Menassa
  • Thomas T. Nguyen
Chapter

Abstract

Implantology has offered an alternative to the conventional denture providing much more stability and retention. This alternative is referred to as an implant overdenture. According to The McGill Consensus Statement on Overdentures (Romanos, Advanced immediate loading, Quintessence Books, 2012, p. 179), the minimum standard of care for an edentulous mandible is a two-implant overdenture. Therefore, in the case of an edentulous mandible, conventional dentures should be considered an alternative treatment. In fact, there are several advantages of two-implant overdentures as they improve support, retention, and stability. Consequently, they improve the patients’ ability to chew food. Patients found implant overdentures more comfortable, and an ease of speech was noted in comparison with a conventional denture (Romanos, Advanced immediate loading, Quintessence Books, 2012, p. 179). Implant overdentures should also be considered for their benefits from a bone-conservation point of view. Implants stimulate the bone and help maintain its level (Davarpanah and Szmukler-Moncler, Manuel d’implantologie clinique: concepts, protocoles et innovations récentes, Paris, 2008).

The timing suggested for implant loading after placement of the implant, which also refers to the delivery of the prostheses, varies. Traditionally, there was a wait period of 3–6 months prior to implant loading in the mandible which is referred to as the conventional loading protocol, introduced initially by Brånemark (Javed and Romanos, J Dent 38:612–20, 2010). In order to reduce this wait period, other protocols have been introduced: immediate loading (under 1 week) and early loading (1 week to 2 months). Additionally, due to improved implant surfaces and techniques, conventional loading is now acceptable as of 2 months (Misch, Contemporary implant dentistry, Elsevier Health Sciences, 2007; Misch et al., J Oral Maxillofac Surg 57:700–6, 1999). There are numerous factors that come into play when determining the appropriate loading protocol.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Clin. dent. Hôpital JuifMontréalCanada
  2. 2.Department of Oral Health, Faculty of DentistryUniversity of MontrealMontrealCanada

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