Über den Autor
Benato Andrea, DMD, Benato Renato MD, DMD
Immediate loading of intraorally welded short Implants
Few studies actually evaluate the outcome of short-length dental implants in immediate loading1. Some studies suggest that short implants achieve similar results as long implants when supporting immediately loaded cross-arch prostheses both in maxillae and mandibles1,2. In the case of immediate loading adequate stability of implants is a very important condition to prevent the risk of micromovements and loss of implants3. Degidi et al published several papers to describe the intraoral welded bar technique that has been proven to offer a solution for the stabilization of the immediately loaded implants4-6. In this report two short Ankylos implants and one long Ankylos implant were welded together intraorally and immediately loaded.
Materials and Methods
An immediate loading was digitally planned in the rehabilitation of a partially edentulous mandible using Simplant® software. On the day of surgery, two premolars with root fracture were removed. Two Ankylos 3,5 x 6,6 mm were inserted in the posterior mandible and one Ankylos 3,5 x 14 mm was placed in the anterior post extraction socket. During implant placement, final insertion torque (FIT) was digitally recorded. Then welding abutments were connected and a 2-mm diameter titanium bar was shaped and intraorally welded to the abutments using the WeldOne™ welding unit. Then the temporary prosthesis was relined and screwed into place. 4 months after the implant placement the provisional restoration was removed and final impressions were recorded. Definitive metalceramic restoration was screwed on posterior abutments and cemented on the anterior abutment.
The immediate post operatory computer tomography scanning demonstrated an implant placement conform the planning in the software. Implants presented a FIT of 18, 36 and 30 Ncm respectively, from posterior to anterior. Clinical status at 1 year following implant placement demonstrated remarkable soft tissue stability. 1-year follow-up radiograph showed stable peri-implant tissues.
- Maló, P./M. A. de Araújo Nobre/A. V. Lopes/R. Rodrigues. 2015. "Immediate loading short implants inserted on low bone quantity for the rehabilitation of the edentulous maxilla using an All-on-4 design". Journal of Oral Rehabilitation. 42 (8): 615-623.
- Cannizzaro, Gioacchino/ Pietro Felice/Jacopo Buti/Michele Leone/Vittorio Ferri/Marco Esposito. 2015. "Immediate loading of fixed cross-arch prostheses supported by flapless-placed supershort or long implants: 1-year results from a randomised controlled trial". European Journal of Oral Implantology. 8 (1): 27-36.
- Szmukler-Moncler, Serge/Adriano Piattelli/Gian Antonio Favero/Jean-Hermann Dubruille. 2000. "Considerations preliminary to the application of early and immediate loading protocols in dental implantology". Clinical Oral Implants Research. 11 (1): 12–25.
Degidi, Marco/Diego Nardi/Adriano Piattelli. 2009. "Immediate rehabilitation of the edentulous mandible with a definitive prosthesis supported by an intraorally welded titaniumbar". The International Journal of Oral & Maxillofacial Implants. 24 (2): 342–347.
- Degidi, Marco/Diego Nardi/Adriano Piattelli. 2010. "Immediate definitive rehabilitation of the edentulous patient using an intraorally welded titanium framework: a 3-year prospective study". Quintessence International. 41 (8): 651–659.
- Degidi, Marco/Diego Nardi/Adriano Piattelli. 2012. "Implants inserted with low insertion torque values for intraoral welded full-arch prosthesis: 1-year follow-up". Clinical Implant Dentistry and Related Research. 14 Suppl 1: e39-45.
The absence of micromotion at the boneimplant interface is fundamental for osseointegration during the healing period. Although no firm clinical consensus has yet been reached, minimum insertion torque values for immediate loading reported in the literature have ranged from 15–50 Ncm. Within the limitations of a single case report the present paper seems to suggest that intraoral welding technique can limit the micromovements of short-implants even when inserted with low torque values providing predictable osseointegration results.