The idea that a patient walks into the practice without teeth and walks out with fixed teeth on implants sounds, to many people, too fast to be serious. Yet with All-on-4 and other All-on-X therapies this is a proven implantology protocol with decades of clinical use behind it.<\/p>\n
Immediate loading, that is, immediate load<\/i>, means that we place a temporary fixed prosthetic restoration onto the implants on the same day or within 24 hours of the procedure. Osseointegration, the fusing of the implant with the surrounding bone, continues beneath the temporary restoration over the following three months or so, after which the temporary teeth are replaced by the permanent fixed prosthetic restoration.<\/p>\n
The key is to understand what this protocol makes possible and what it does not, because the difference between success and failure lies in a few very concrete details.<\/p>\n
With delayed loading, the implant first fuses with the surrounding bone over several months, and only once osseointegration is complete does the crown or bridge follow. With immediate loading, the temporary fixed teeth are placed on the same day or within 24 hours, while the process of osseointegration continues over the following three months or so.<\/p>\n
An important difference we explain to patients again and again is that during that period the temporary fixed restoration mainly has an aesthetic and phonetic function, and shapes the soft tissues as they heal. At the same time, by joining the implants into a single fixed structure, the temporary restoration contributes to stabilising them and to limiting micro-movement during osseointegration.<\/p>\n
That, however, does not mean the temporary teeth can be used to bite and chew as usual. During osseointegration the patient follows an adapted diet and the instructions they have been given, so as to avoid excessive load on the temporary restoration and on the implants and to protect the conditions needed for them to fuse stably with the surrounding bone.<\/p>\n
The whole immediate loading protocol rests on one key concept: primary stability<\/b>. This is the mechanical stability of the implant in the bone immediately after placement, before its biological bond with the surrounding bone begins. One way of assessing it is the insertion torque when the implant is placed, expressed in newton centimetres (Ncm). For immediate loading, the literature often cites values of roughly 30 to 40 Ncm and above, while a further assessment can be made with resonance frequency analysis, where ISQ values above 65 are considered favourable for implant stability (Tettamanti et al., 2017).<\/p>\n
Why primary stability matters so much is best explained by micro-movement. A review of the experimental and clinical literature shows that a certain level of micro-movement is not an obstacle to osseointegration, but the literature cites a critical range of approximately 50 to 150 micrometres. Excessive micro-movement can compromise osseointegration and increase the risk that connective tissue forms instead of a stable bony bond with the implant (Tettamanti et al., 2017).<\/p>\n
With All-on-4 and other All-on-X therapies we do not look only at the stability of each implant separately. What matters is their position and distribution, as well as the way they are joined by the temporary fixed prosthetic restoration, through which the implants act as one biomechanical unit and micro-movement during osseointegration is limited. This is precisely why the number of implants in itself is not decisive. What matters is where the implants are placed, what stability they have and how the forces are distributed across the whole structure.<\/p>\n
With a single implant there is no biomechanical advantage of joining several implants together such as we have with All-on-X therapies. Immediate loading of a single implant is possible in properly selected cases, but the decision is made individually. The possibility of immediate loading is therefore not determined by one measured number, but by the combination of anatomy and bone characteristics, the primary stability of the implant and the biomechanics of the planned prosthetic restoration.<\/p>\n
The data are encouraging when the protocol is applied in properly selected cases. An extensive systematic review of more than ten thousand immediately loaded implants showed a survival rate of 96.39 percent with follow-up of up to 13 years, with the great majority of recorded failures, around 97 percent, occurring within the first year (Del Fabbro et al., 2006). This is an important finding that further underlines the importance of the early healing period, of regular check-ups and of the patient following instructions.<\/p>\n
The question of a torque threshold is interesting as well. A more recent meta-analysis showed that a lower insertion torque was not in itself associated with significantly lower survival of immediately loaded implants over an average follow-up of two years, which suggests that the outcome is decided by the case as a whole and not by one single number (Darriba et al., 2023). In planning, therefore, we look at bone quality, implant distribution and the design of the temporary restoration together rather than in isolation.<\/p>\n
For completely edentulous patients, or those with teeth that can no longer be preserved long term because of advanced periodontitis, immediate loading is most often applied in the context of fixed teeth within 24 hours. The best known such concept is All-on-4, in which the whole dental arch is replaced by a prosthetic restoration fixed onto four strategically distributed implants. Its broader and more individualised development is the All-on-X concept, where the “X” indicates that the number, distribution and type of implants are not set in advance but are adapted to the patient’s anatomy and clinical situation.<\/p>\n
With immediate loading, temporary fixed teeth are placed onto the implants on the same day or within 24 hours of their placement. This loads the implants and joins them into a biomechanical unit. The temporary fixed teeth are worn during the roughly three months of osseointegration, after which they are replaced by the permanent fixed prosthetic restoration. A systematic review of the All-on-4 concept reported implant survival above 99 percent after more than two years, with the authors noting that the quality of the available studies still has limitations (Soto-Penaloza et al., 2017).<\/p>\n
At Ortoimplant DENTAL SPA this approach is particularly important also in patients with a pronounced lack of jawbone, in whom placing conventional implants is not possible. We then use the bone potential of higher anatomical regions of the head, such as the cheekbone, the Z-point beside the nasal cavity or the pterygomaxillary area at the base of the skull, applying advanced implantology techniques such as transnasal, zygomatic, transsinus and pterygoid implants.<\/p>\n
The treatment of demanding cases of edentulism and pronounced atrophy of the jawbone is precisely the specific niche of the implantology work of Ortoimplant DENTAL SPA. When conventional implantology cannot offer a fixed solution because of a pronounced lack of bone, advanced implantology techniques allow us to find, in a large number of cases, another safe bony anchorage. Which technique, and which number, type and distribution of implants we apply, is determined by the patient’s individual anatomy and by the plan for the future fixed prosthetic restoration. We do not adapt the patient to the All-on-4 concept. We adapt All-on-X to the patient’s anatomy.<\/b><\/p>\nWho is a good candidate and who is not<\/h2>\n
Immediate loading is not universally applicable, and the decision to use it is always based on an individual clinical assessment. Suitability depends on several factors that we assess during diagnostics and during the procedure:<\/p>\n
At Ortoimplant DENTAL SPA immediate loading is a standard part of the All-on-X protocol, so as a rule patients receive temporary fixed teeth on the same day or within 24 hours of the procedure. Very rarely, in specific and clinically particularly demanding situations, individual anatomical and biological conditions may call for a different approach. If the primary stability of the implants does not allow safe immediate loading, we do not force it. We then leave the implant to fuse with the surrounding bone without immediate load, and place the fixed prosthetic restoration later. That is not a step backwards, it is a decision in favour of durability.<\/b><\/p>\nWhat you can expect after the procedure<\/h2>\n
The temporary fixed teeth are worn during osseointegration, roughly three months. In that period we monitor the healing of the bone and the shaping of the soft tissues. Once the expected period of osseointegration and the check-up are complete, we replace the temporary restoration with the permanent fixed prosthetic restoration, made individually for optimal function and aesthetics.<\/p>\n
In the concept of new fixed teeth in a single day at Ortoimplant DENTAL SPA, alongside local anaesthesia we apply potentiated analgosedation as a matter of protocol, supervised by an anaesthesiologist, with intravenous administration of medication and supplementation according to the patient’s individual needs. Local anaesthesia ensures that the patient feels no pain during the procedure, while analgosedation removes fear and discomfort and allows the patient to sleep through such an often extensive implantology procedure and, most often, to remember little or nothing of it.<\/p>\n
DENTAL SPA treatments accompany the patient before, during and after the procedure, with the aim of preparing and supporting the body, making the experience of treatment more comfortable and creating favourable conditions for healing and for the processes important to osseointegration. Depending on the patient’s individual needs, they include lymphatic drainage, intravenous supplementation, ozone therapy, hilotherapy, magnetotherapy and, where indicated, hyperbaric oxygen therapy.<\/p>\n
The most important thing to understand is that speed is not a trick. New teeth in a single day are the result of careful selection, precise planning and measurable conditions at placement. When those conditions are met, the patient goes home with fixed teeth.<\/p>\n
For a well selected patient, yes. Immediate loading means we place a temporary fixed restoration on the implants within 24 to 48 hours of placement, instead of the conventional three to six months of waiting. It is not a universal solution, and we assess suitability at the examination and during the procedure itself.<\/p>\n<\/div>\n
A large systematic review of more than ten thousand immediately loaded implants reported survival of 96.39 percent with follow-up of up to 13 years. The great majority of failures, around 97 percent, occurred within the first year, which is when check-ups and patient discipline matter most. For concepts such as All-on-4, a systematic review reported implant survival above 99 percent after more than two years, with the authors noting that the quality of the available studies still has limitations.<\/p>\n<\/div>\n
Not straight away. In the first weeks the temporary restoration is not there to be chewed on at full force: it shapes the gum, restores appearance and function within reasonable limits, and holds the space while the bone does its work. A willingness to stick to softer food and the agreed check-ups in the first weeks is one of the conditions for this protocol.<\/p>\n<\/div>\n
Suitability depends on bone density and volume, on the insertion torque and stability measured during the procedure, on teeth grinding, on general health and smoking, and on your willingness to accept softer food and check-ups in the first weeks. If stability is not sufficient at the moment of placement, we do not force it. Instead we let the implant heal on the conventional schedule and fit the fixed restoration a little later.<\/p>\n<\/div>\n
The price depends on the number of implants, the condition of the bone, the need for more demanding techniques and the type of final prosthetics, so it is set after an examination and a CBCT scan. The first examination at Ortoimplant DENTAL SPA is free, and there you receive the plan and the price for your own case.<\/p>\n<\/div>\n<\/div>\n
The phrase “teeth in a day” sounds like marketing. It isn’t. Fitting a fixed set of teeth within roughly 24 hours of placing the implants is a defined surgical protocol with decades of published evidence behind it. What makes it possible is not a faster-healing implant, but a different sequence: the temporary bridge goes on before the bone has fused to the implant, and the implants are engineered to hold that bridge steady while healing happens underneath.<\/p>\n","protected":false},"author":2,"featured_media":1167,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[32],"tags":[],"class_list":["post-870","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-implant-procedure-en"],"acf":[],"_links":{"self":[{"href":"https:\/\/ortoimplant.hr\/en\/wp-json\/wp\/v2\/posts\/870","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ortoimplant.hr\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ortoimplant.hr\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ortoimplant.hr\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/ortoimplant.hr\/en\/wp-json\/wp\/v2\/comments?post=870"}],"version-history":[{"count":2,"href":"https:\/\/ortoimplant.hr\/en\/wp-json\/wp\/v2\/posts\/870\/revisions"}],"predecessor-version":[{"id":1360,"href":"https:\/\/ortoimplant.hr\/en\/wp-json\/wp\/v2\/posts\/870\/revisions\/1360"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ortoimplant.hr\/en\/wp-json\/wp\/v2\/media\/1167"}],"wp:attachment":[{"href":"https:\/\/ortoimplant.hr\/en\/wp-json\/wp\/v2\/media?parent=870"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ortoimplant.hr\/en\/wp-json\/wp\/v2\/categories?post=870"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ortoimplant.hr\/en\/wp-json\/wp\/v2\/tags?post=870"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}