Prosthetic Requirements for Immediate Implant Loading: A Review

Purpose: The aim of this article is to review the current literature with regard to prosthetic considerations and their influence on the outcome of immediately loaded implants. Materials and Methods: A broad search of the published literature was performed using MEDLINE and PubMed to identify pertinent articles. Results: One hundred fifty six references were selected. They were mainly descriptive, prospective, follow-up studies. They were reviewed and were categorized with respect to 6 factors that influence immediate loading: cross-arch stability and micromovements, interim prostheses, definitive restorations inserted immediately, screw- or cement-retained prostheses, occlusion, and number and distribution of implants in overdentures and fixed prostheses. Conclusion: Immediate loading seems to be a relatively safe procedure. From the prosthodontic point of view, there are specific guidelines to follow. They are: implants should be splinted with a metallic bar and acrylic interim prostheses until full osseointegration occurs. To have a successful outcome, screw-retained interim prostheses are recommended. CAD/CAM systems can improve the placement of implants with minimum risk. Regarding occlusion, there is a disagreement on when and how to provide occlusal contacts, but all authors agree on keeping centric contacts only. Finally, concerning the number of implants required for an immediate overdenture, no conclusive evidence could be found.