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Surely you have ever seen advertising on television, press or the internet that promises “Teeth in a Day” through the placement of dental implants and fixed prostheses on them.
The big question that most people ask is if this is true, if it is possible to perform dental work of this magnitude in just a few hours, since at first glance it seems something too good to be real.
The consolation is that it is not a myth, it is a reality (albeit half), it is possible to do it; and in fact, many clinics are exclusively dedicated to this type of treatments.
However, “not all that glitters is gold” and to execute this protocol the patient must meet a series of ideal clinical conditions that are often difficult to find. In addition, it requires a lot of planning, as well as multiple visits to the clinic; that serve to evaluate, diagnose and prepare everything for that special day. As we can see, then it is no longer a 100% reality.
The treatment protocol known in the United States as “Teeth in a Day,” generally refers to a procedure in which all remaining teeth are removed from the mouth, multiple dental implants are placed, and a full-arch provisional restoration is attached over them; all on the same day, in the same clinical session. Several months later, once the osseointegration period has elapsed, the definitive prosthesis is made.
Also, it is possible to apply this protocol to the replacement of an individual tooth, by placing an implant and then a temporary plastic crown.
However, patients who are interested in and in awe of this option to restore their smile with dental implants, must understand four basic concepts in order to make a correct and well-informed decision regarding safety, comfort, function and aesthetics offered by this treatment protocol.
1- Osseointegration
It is defined as the biological process by which a functional ankylosis is achieved between an implant and its recipient bone. The implants are made of titanium, a biocompatible and osteoinductive metal, capable of stimulating the differentiation of osteoblasts and initiating the process of healing and bone regeneration (osteogenesis) around them.
This phenomenon takes between 3 and 6 months of time, and it is what allows an implant to be firmly fixed to the bone, to remain stable over time and to be used safely as a base or abutment for dental prosthesis.
2- Loading Concept
The loading of an implant consists of making it work, fixing a crown, a bridge or a denture on it. When loading an implant, it is immediately subjected to the effects of forces generated by occlusion, chewing and other oral functions.
3- Immediate Loading
The immediate loading of a dental implant is a treatment protocol that consists of a single-stage surgery, in which the implant is put to work with a provisional fixed restoration at the same appointment as its placement or shortly after (3 or 4 days), without waiting for the healing period (osseointegration) to elapse.
4- Delayed Loading
Conventional treatment protocols with endosseous dental implants have always required a variable healing or osseointegration period (generally between 3 and 6 months), before placing the restoration and being able to load the implants. The osseointegration period is considered necessary to achieve the correct fixation of the implant to the bone and to achieve a stable and reliable load support interface.
The traditional protocol has always given the best long-term clinical results, no one should debate it! However, there is a growing trend in the profession aimed at reducing treatment times associated with dental implant placement, to reduce patient discomfort and anxiety, increase procedure acceptance rates, and immediately achieve better aesthetics and function.
But while it seems very noble and valid, it is important to know the negative implications associated with “Teeth in a Day” protocols, supported by a large number of recent scientific studies and clinical trials.
Risks and Disadvantages of Immediate Loading in Oral Implantology
Although it is an increasingly common and frequent procedure, some of the risks, limitations and possible complications involved with immediate loading implants are described below. Many clinics do not offer this type of service for the following reasons:
1- They are only viable in a very small number of cases.
2- The implants placed must be at least 10 mm long and 3.5 mm in diameter.
3- Greater possibility of destabilization and immediate mobility.
4- They are up to 6 times more likely to fail, compared to delayed loading implants.
5- Over time, “Teeth in a Day” procedures tend to show a less predictable bone reaction, greater marginal bone loss, and lower trabecular density.
6- There is very little scientific documentation in cases of partial edentulous.
7- Great difficulty in hygiene and wound control.
8- Most unfavorable postoperative period, with greater discomfort for the patient.
9- Need for a large number of visits and periodic adjustments of the prosthesis.
If you have any doubts about it, we recommend that you do a brief review of scientific articles on the internet, of course, ignoring those of an advertising nature or those exposed by private dental clinics; so that you can draw your own conclusions.
Zygomatic Implants: The Great Exception
With long implants, the story is another. These devices are much larger and more resistant, they are anchored to facial bones that are much more compact and voluminous than the jaws, and their fixation is more mechanical than histological; reasons for which they do not directly depend on the phenomenon of osseointegration.
With zygomatic implants, immediate loading is the protocol of choice, unlike conventional dental implants.
Speaking with Honesty and Sincerity …
If you have come this far, and despite the respectable opinion of other colleagues, you may have easily inferred that we do not like “Teeth in a Day”, we do not like immediate loading on conventional dental implants and we do not recommend it to any of our patients. At DENTAL VIP we were trained under the delayed loading protocol and we continue to consider the phenomenon of osseointegration as the best guarantee of success in the short, medium and long term.
In addition, we frequently receive patients from other clinics with these treatments seeking a second opinion for discomfort or mobility of their implants. That discourages us a lot!
However, we must confess that we occasionally perform the procedure, of course; as long as the patient is well informed, he expressly requests it, meets the ideal conditions and is willing to take the associated risk.
The fact of not applying immediate load on the implants does not mean that the patient should be without teeth. Normally, we make an immediate removable prosthesis that is installed the same day as the implant surgery, and that temporarily solves the aesthetic request.
If you are considering having dental implants, our best advice is to seek multiple opinions. If you go to only one clinic, you will only have one criteria and you will not be able to make comparisons nor deductions.
At DENTAL VIP, we offer the oral implantology service as part of our restorative Dentistry practice. We have the experience of a highly trained Oral Surgeon and we only work with the best dental technicians in the city; to create beautiful, comfortable, functional and long-lasting smiles and rehabilitations.
“The Most Sensible and Safest Thing in Oral Implantology, Is to Avoid the Rush and Always Respect Therapeutic Times”.
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