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Tips from Our Readers| Volume 121, ISSUE 2, P358-360, February 2019

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Immediate occlusal loading of implants: A rapid chairside procedure for making an interim fixed prosthesis

  • Gerald Maille
    Correspondence
    Corresponding author: Dr Gérald Maille, UFR Odontologie de Marseille, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 05, FRANCE
    Affiliations
    Assistant Professor, Department of Fixed Prosthodontics and Implant Dentistry, Aix-Marseille University, Timone Teaching Hospital, Marseille, France
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  • Eric Loyer
    Affiliations
    Assistant Professor, Department of Fixed Prosthodontics and Implant Dentistry, Aix-Marseille University, Timone Teaching Hospital, Marseille, France
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Published:August 22, 2018DOI:https://doi.org/10.1016/j.prosdent.2018.02.008
Immediate occlusal loading of implants: A rapid chairside procedure for making an interim fixed prosthesis
Previous ArticleThree-dimensional printed definitive cast for a silicone obturator prosthesis: A clinical report
Next ArticleAccurate repositioning of an implant interim restoration into the definitive impression to obtain an exact reproduction of tissue contours in the soft tissue cast
      This technique provides the patient with an interim fixed prosthesis at the time of implant placement.
      • Mazaro J.V.
      • Vedovatto E.
      • Gennari Filho H.
      • Pellizzer E.P.
      A modified method of immediate occlusal loading using a reinforced framework denture: a case report.
      Dent Today. 2009; 28 (78, 80, 82)
      , 
      • Attard N.J.
      • Zarb G.A.
      Immediate and early implant loading protocols: a literature review of clinical studies.
      J Prosthet Dent. 2005; 94: 242-258
      , 
      • Lazzara R.J.
      • Testori T.
      • Meltzer A.
      • Misch C.
      • Porter S.
      • del Castillo R.
      • et al.
      Immediate occlusal loading (IOL) of dental implants: predictable results through DIEM guidelines.
      Pract Proced Aesthet Dent. 2004; 16: 3-15
      , 
      • Szmukler-Moncler S.
      • Piattelli A.
      • Favero G.A.
      • Dubruille J.H.
      Considerations preliminary to the application of early and immediate loading protocols in dental implantology.
      Clin Oral Implants Res. 2000; 11: 12-25
      In the described treatment, the procedure lasted 5 hours from the start of surgery until the patient left the office. Six implants were placed in the maxilla by using the immediate complete denture as a surgical guide.

      Procedure

      • 1.
        Modify the existing complete denture to fit over titanium impression posts (temporary coping Ø 4; Anthogyr) (Fig. 1A, 1B ).
        Figure thumbnail gr1
        Figure 1A, Modification of removable denture. B, Clinical appearance. C, Protection of titanium cylinders and insertion of rubber dam. D, Hole made in canine region.
      • 2.
        Close the screw access holes with polytetrafluoroethylene (PTFE) tape, and insert a sheet of rubber dam (medium; Nic Tone) to act as a barrier for the autopolymerizing resin (Fig. 1C).
      • 3.
        Make 2 holes on the edge of the denture at the level of the canines (Fig. 1D).
      • 4.
        Guide the patient to a closed position and then inject acrylic resin (Unifast Trad pink; GC Corp) with a syringe through the holes. At this stage, when the resin has completely polymerized, the occlusion is locked (Fig. 2A).
        Figure thumbnail gr2
        Figure 2A, Resin injected in canine region to lock occlusion. B, Injection in posterior region.
      • 5.
        Carry out the same procedure at the posterior location (Fig. 2B).
      • 6.
        After the resin has completely polymerized, remove the denture including the titanium cylinders. The rubber dam provides excellent tissue protection (Fig. 3A-C).
        Figure thumbnail gr3
        Figure 3A, Immediately after prosthesis removal, rubber dam prevented resin flowing on mucosa. B, Intaglio surface of prosthesis. C, Cameo surface of prosthesis. D, Finished prosthesis after removal of palate and buccal extension.
      • 7.
        Remove the flanges of the denture and adjust the intaglio surface to allow access for hygiene (Fig. 3D).
      • 8.
        Secure the interim prosthesis with prosthetic screws, and reevaluate and adjust the occlusion (Fig. 4).
        Figure thumbnail gr4
        Figure 4Seated interim prosthesis.

      References

        • Mazaro J.V.
        • Vedovatto E.
        • Gennari Filho H.
        • Pellizzer E.P.
        A modified method of immediate occlusal loading using a reinforced framework denture: a case report.
        Dent Today. 2009; 28 (78, 80, 82)
        View in Article
        • Attard N.J.
        • Zarb G.A.
        Immediate and early implant loading protocols: a literature review of clinical studies.
        J Prosthet Dent. 2005; 94: 242-258
        View in Article
        • Lazzara R.J.
        • Testori T.
        • Meltzer A.
        • Misch C.
        • Porter S.
        • del Castillo R.
        • et al.
        Immediate occlusal loading (IOL) of dental implants: predictable results through DIEM guidelines.
        Pract Proced Aesthet Dent. 2004; 16: 3-15
        View in Article
        • Szmukler-Moncler S.
        • Piattelli A.
        • Favero G.A.
        • Dubruille J.H.
        Considerations preliminary to the application of early and immediate loading protocols in dental implantology.
        Clin Oral Implants Res. 2000; 11: 12-25
        View in Article

      Article info

      Publication history

      Published online: August 22, 2018

      Identification

      DOI: https://doi.org/10.1016/j.prosdent.2018.02.008

      Copyright

      © 2018 by the Editorial Council for The Journal of Prosthetic Dentistry.

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