Immediate loading means that the inserted implant body will immediately get restored (or loaded as we say) with an implant crown. The implant can either be placed in bone of an already existing tooth gap or if an extraction was indicated as well into the fresh extraction site.
The words "same day implants" indicate the same concept of immediate restoration (within 24hours) but is mainly used commercially by different institutions.
Theoretically, every implant can be loaded immediately if the implant shows a sufficient primarily stability.
In reality, immediate restoration of freshly placed implants is most useful in the aesthetic area which means front teeth (incisors, canines, premolars) - so the patient doesn't show any tooth gaps when smiling which is of particular importance if extractions need to be performed as well.
In case of posterior molar teeth, an immediate restoration does not have superior advantages thus the alternative conservative approach of restoring the implant after a healing period of several weeks is usually performed in posterior areas.
The range of indicated extractions can indeed span from a single tooth to multiple teeth and can even end up with removal of all teeth of one jaw.
The exact course of proceeding with multiple extractions is discussed and planned with the patient prior to surgery and will be performed in a way that is therapeutically useful and in the comfort zone of the patient.
The immediate restoration of a tooth (that needs to be extracted) with implant and implant crown has many benefits. It preserves the existing bone as well as the existing soft tissue around the former tooth (now implant) in the most reliable way showing the most pleasing aesthetic results in the long term.
A tooth extraction especially of upper front teeth is a psychological traumatic experience to most patients. Being able to provide an immediate solution for the patient within one session of 2 hours (from extraction to dental restoration) is perceived very positively.
The only drawback of immediate restoration of implants might be the fact that the patient is not allowed to eat on it for several weeks until the implant body has properly fused (osseointegrated) with the surrounding bone. Any kind of tooth contact with the new implant tooth should be avoided prosthetically in order not to jeopardise the healing. That's why we prefer to use a temporary less precious implant crown first that will be replaced with the permanent highly aesthetic one after a healing time of usually 12 weeks.
Obviously, the patient needs to be seen first for a surgical as well as prosthetic consultation where relevant x-rays and impressions need to be taken for planning of each individual case and were alternative therapies can be discussed.
Already in the second appointment, the surgery (performed under normal local anaesthesia) can take place with immediate placement of implant crown.
Interestingly when implants are inserted immediately into extraction sites the healing-process seems favourably improved. Nevertheless, a little bit of discomfort or pain from the extraction itself with mild swelling and somethings bruising is to be expected.
All patients are prescribed a medication regimen of antibiotics and painkillers for the post-operative days.
Such dental surgeries should be planned according to the patients activity schedule. It is useful to abstain from any physical exercise for 3-5 days but only very few patients, in general, would need days off from work.
Approximately one week after surgery a joint surgical/prosthetic follow up visit will be scheduled to ensure an uneventful healing.
Approximately 12 weeks later, the patient will be seen again for replacement with permanent implant crown. Once the implant is restored, the patient should keep their normal 6-monthly check-ups.