Recently, I’ve been hearing some intense debates over immediate loading vs. delayed loading protocols. There are compelling arguments for each side. There is also substantial literature that can support either view, so it can be confusing when you’re considering adding this treatment to your repertoire.
Here are some case pictures showing immediate placement for a molar and immediate provisionalization for a lateral incisor along with some step-by-step commentary by Dr. Stephen Park.
#Immediateplacement of lower first and second molar 1.Fractured first molar and second molar with apical lesion 2. tough extraction for the first molar. Again arrow showing initial drilling through the fractured tooth 3. Socket after finial drill and removal of root. Notice on the mesial of the first molar had a small root tip with gutta purcha still in it. I managed to remove it. 4. #Implant placed (story continues with what actaully happened) I wanted to talk little bit about planning and what happens when I place these 5. arrow pointing to proposed implant site. Because of the shape of the second molar we plan to place more mesial. For the first molar I was aiming for the mesial root and the apical bone. 6. the second molar site was easy to place with great initial stability but for the first molar site I had trouble getting initial stability with 5.5 mm implant and when I got initial stability it was too low compare to the other. 7. changed out the implant to a 6.0 mm and I was able to get initial stability at the level I wanted for the first molar. Again Initial stability of a immediate placement of a molar is mostly through apical bone in most case.(I will share a case where I will get initial stability because of spetal bone) I hope this helps #implants #implantguru #implant_guru #implantsurgery #implantdentisty #dentalimplant #osseointegration #advancedoralrehabilitation #치아이식 #임플란트 #dentalphotography #dentalsurgery #prosthodontics #prosthodontist #dentisimplant #onephotolecture
#immediateloading #immediateplacement of a lateral. If you want to try this select a case with lower esthetic demand as this case was. Remove the tooth carefully and place the implant engaging the palatal bone. I always try to get a screw temporary but for this case slop of the ridge required a cementable temporary. I always have some milled abutments around from other cases and I used it here. Essentially from now on this case becomes a regular crown we are temporizing. Prefab crown is used to reline and trim to customize. Under contouring the gingival portion is the key. Remember that these abutments have natural shape to help in that. Cemented with very little cement and make sure to remove all excess. Really wanted to show a screw temporary but have found a case to show the steps yet. Thanks for viewing. #implant #implants #implantguru #implant_guru #implantdentistry #advancedoralrehabilitation #osseointegration #dentalsurgery #dentalimplant #dentalphotography #hiossenimplants #cosmeticdentist #cosmeticdentistry #estheticdentistry #aestheticdentistry #surgicalprosth #surgicalprosthodontics #surgicalprosthodontist #prosthodontistrule #prosthodontist #prosthodontics #onlyprosthodontist #치아이식 #임플란트
A photo posted by Dr. Steven Park DDS MS (@implantguru) on
The decision tree for immediate placement and loading is complex and the procedure can be highly technique sensitive. If there is sufficient interest in this (from you), I’ll begin a thread explaining the technique in detail.
- Are you immediately placing implants at your office?
- Any experiences to share with us?
- Is this something you’d be interested in learning more about?
Let me know by dropping a comment!
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