Sufficient primary stability is prerequisite for immediate implant loading. In this surgical video, Dr. Wolfgang Bolz , Munich/Germany, carries out an implantation in the upper jaw with integration of fixed dentures as part of immediate loading. A particular anatomical feature of this patient was that her acute periodontitis was accompanied by extremely soft bone. It was nevertheless possible to achieve sufficient primary stability, which is prerequisite for immediate loading.
Extraction and degranulation are followed by an incision and preparation of a mucoperiosteal flap. The existing bone edges are removed and the height of the alveolar ridge is reduced. For successful results, immediate loading requires high primary stability. This is difficult to achieve due to the softness of the bone, however it is possible by reducing the distance drilled and repositioning the implant.
The bed for the temporary dentures is flattened and smoothed so that as a result of slight pressure during immediate loading, the denture seat can take shape and subsequently be cared for without undue effort. In this patient, a combination of immediate implantation and immediate loading allowed the implants to heal well, also ensuring that conditions in the peri-implant area were stable in the long-term.