Page 6 Implant News & Views Fig. g u Two Important Implant Concepts Reviewed and Referenced Five Things to Know About Teeth in a Day with Dental Implants Kelvin I. Afrashtehfar D.D.S., FADI, FADFE Shahrokh Esfandiari, B.Sc., M.Sc., D.M.D., Ph.D. This is a brief educational evidence-based article intended to be useful to practicing clinicians. Five key statements focused on the most significant information on immediate implants are reviewed. 1. The “teeth in one-day” concept or immediate loading protocol refers to placing the prosthetic component in function the same day the dental implants have been placed As demonstrated in a 15-year clinical trial, traditional two-stage implant placement produces exceptionally successful restorative method in edentulous jaws. 1 In a prospective case-series, researchers also revealed comparable results for osseointegration with implants using this one-stage immediate loading protocol. 2 2. Immediate loading of oral implants has become popular because of surgical and time benefits A systematic review shows that surgical intervention is avoided and the treatment time is shortened with this one-stage approach which may be a preferred treatment modality for partially edentulous patients. 3 3. This modality is more reliable for the mandible than the maxillae A systematic review has shown predictable results on immediate implant loading only in the mandible. 4 However recent retrospective study shows that although the immediate implant placement and its loading in the mandible does not increase failure rates, it may increase it in the maxillae. 5 4. Success is determined by a proper case selection: bone quality, primary stability, no need of barriers, partially edentulous, etc. One systematic review offers enough evidence for immediate loading of maxillary overdentures. 6 Meanwhile, another one finds that good bone quality and longer implants are indispensable for success. 4 Another systematic review finds that although the primary stability is crucial for success, there is no need for guided tissue regeneration barriers. 3 It also reveals that one-stage modality may be suitable in partially edentulous patients and the fully edentulous patients are favored with two-stage implant placements. 3 5. Similarly to popular belief, there is some evidence suggesting benefits of prophylactic antibiotics A systematic review suggests that it is reasonable to advocate the use of a single dose of 2gr prophylactic amoxicillin prior to implant placement. However, antibiotics postoperative benefits are still unknown. 7 References 1. Adell R, Lekholm U, Rockler B, Branemark PI. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 1981;10(6):387-416. 2. Balshi SF, Wolfinger GJ, Balshi TJ. A prospective study of immediate functional loading, following the Teeth in a Day protocol: a case series of 55 consecutive edentulous maxillas. Clin Implant Dent Relat Res 2005;7(1):24-31. 3. Esposito M, Grusovin MG, Chew YS, Coulthard P, Worthington HV. Interventions for replacing missing teeth: 1- versus 2-stage implant placement. Cochrane Database Syst Rev 2009(3):CD006698. 4. Strub JR, Jurdzik BA, Tuna T. Prognosis of immediately loaded implants and their restorations: a systematic literature review. J Oral Rehabil 2012;39(9):704-17. 5. Testori T, Zuffetti F, Capelli M, et al. Immediate versus Conventional Loading of Post-Extraction Implants in the Edentulous Jaws. Clin Implant Dent Relat Res 2013. 6. Gallucci GO, Morton D, Weber HP. Loading protocols for dental implants in edentulous patients. Int J Oral Maxillofac Implants 2009;24 Suppl:132-46. 7. Esposito M, Worthington HV, Loli V, Coulthard P, Grusovin MG. Interventions for replacing missing