Diagnosis and Planning in Immediate Loading: Implant Selection

  • Ugo Covani
  • Enrica Giammarinaro
  • Simone Marconcini
  • Javier Aizcorbe-Vicente
  • Miguel Peñarrocha-DiagoEmail author


Despite the increasing patients’ desire for immediate prosthetic loading of implants, several factors must be taken into account before pursuing the immediate loading (IL) protocol. In general, the number, size, characterization, and distribution of implants should be based on the implant-prosthodontic plan, arch form, and available bone quality and quantity, regardless of the loading protocol. However, implant selection in IL represents one of the most important clinical challenges due to the primary stability requirement.

Implant diameter and length have been qualified as key factors in IL procedures, since they directly influence the primary stability of dental implants. However, there is no exhaustive indication regarding optimal implants’ length and diameter.

The main indication for IL is the total edentulism in a patient who is unable to tolerate a removable prosthesis. Possible rehabilitations include implant overdentures, implant Toronto bridges, and fixed metal or zirconia ceramic implant full-arches. The main recommendation, in edentulous patients, is to achieve a uniform forces distribution along the alveolar arch, irrespective of the number of placed implants, and to minimize the need of cantilevers with the use of distally tilted implants. The number of implants used to support a fixed prosthesis varied from 2 to 10 in the mandible and 4 to 12 in the maxilla. This difference is due to the different bone composition in the upper and in the lower jaw. However, no relationship between the number of implants and the prosthetic success was found.


Immediate loading Treatment planning Edentulous jaws Full-arch Implant selection 



Immediate loading


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Ugo Covani
    • 1
  • Enrica Giammarinaro
    • 1
  • Simone Marconcini
    • 1
  • Javier Aizcorbe-Vicente
    • 2
  • Miguel Peñarrocha-Diago
    • 2
    Email author
  1. 1.Department of Surgical, Medical, Molecular and Critical Area PathologyUniversity of PisaLido di Camaiore (LU)Italy
  2. 2.Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and DentistryUniversity of ValenciaValenciaSpain

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