Recommended loading protocols for dental implants in edentulous and partially edentulous patients with fix or removable prosthesis

Patients’ levels of knowledge and expectations for treatment with dental implants have increased tremendously in recent years. Also treatment with dental implants has proven to be a predictable modality for replacing missing or failing teeth with various types of fixed or removable dental prosthesis. It was traditionally thought that the healing period of 3 to 6 months is necessary. Recent studies show high level of survival rates with immediate and early loading. The object of this study was to evaluate current evidence for evaluating recommended loading protocols for dental implants. Method & Materials: A comprehensive systematic review of the literature was conducted by using Pubmed and Science Direct by the end of September 2010. The selection of publications reporting on human clinical studies was based on predetermined inclusion criteria. One hundred thirty eight out of 971 papers were approved for inclusion criteria. 39 were discussing early loading. 40 were discussing immediate loading and 57 were discussing conventional loading and 7 were discussing fresh socket implant placements. Existing literature supports loading of micro roughened implants in edentulous and partially edentulous maxilla and mandible between six and eight weeks subsequent to implant placement with fix or removable prosthesis, it’s also possible to load dental implants in mandible in less than one week after placement with fix and removable prosthesis. But current evidence does not support loading edentulous and partially edentulous maxilla in less than eight weeks and recommends conventional loading (after three months). Special consideration such as lack of primary stability, alveolar ridge augmentation, sinus floor elevation, presence of parafunction, compromised host status and dental complication should be considered as risk factors for immediate and early loading. In these situations conventional loading is recommended. Loading between two and six weeks are not recommended.