Immediate load implants with prosthetic rehabilitation supported by implants in the anterior area: Clinical case presentation

Usage of implant-supported prostheses is a treatment alternative for patients requiring replacement of one or more teeth. Modifications have been undertaken with respect to surgical and prosthetic protocols, by reducing the load time of the implant, so as to satisfy demands for faster treatments, and to reduce patient’s discomfort during healing time.1 Functional immediate load is the most recent concept. This describes a load, within physiological limits, applied to implants before the osseo-integration process is completed.2 According to the American Periodontics Academy, osseo-integration is the direct relationship at microscopic level between bone and the implant surface. The biological process of osseo-integration comprises 3 phases: 1) osteolytic phase, where a generalized inflammatory response is observed. In this response, numerous amounts of cytokines are released. These cytokines regulate production of adhesion molecules and alter cellular proliferation regulating bone metabolism. During the first week, there is migration of osteoblasts derived from trabecular bone endosteum. 2) Osteo-conductive phase: Bone cells are observed around the implant. A fibrocartilaginous callous is formed. It eventually is remodeled by a bone callous. This is observed after three months. 3) Osteoadaptive phase. This phase takes place approximately four months after implant placement. In this phase, a subsequent bone remodeling is observed after exposing and loading the implant. Immediate load implants with prosthetic rehabilitation supported by implants in the anterior area: Clinical case presentation