Immediate Occlusal Loading in Edentulous Jaws, CT-Guided Surgery and Fixed Provisional Prosthesis: A Maxillary Arch Clinical Report

Immediate occlusal loading (IOL) in edentulous jaws has been reported in numerous publications with implant cumulative survival rates consistent with conventional, unloaded healing protocols. Computed Tomography (CT)-guided surgery has more recently been developed and accepted as an additional treatment modality for maxillary and mandibular implant placement, with or without IOL. Reports as to the accuracy of planned versus actual implant placement in CT-guided surgeries have indicated that CT-guided surgery is not 100% accurate; standard deviations have been reported with values between 1 and 2 mm in terms of actual versus planned placement. The purpose of this article is to review the clinical parameters associated with IOL, and CT-guided surgery in edentulous jaws; and to present a clinical case illustrating the clinical and laboratory phases of treatment. The illustrated treatment was accomplished with an IOL protocol and includes fabrication and placement of a laboratory-processed provisional maxillary prosthesis. This particular protocol had slightly increased costs relative to conventional implant placement; however, the clinicians and patient benefited from improved accuracy of the provisional prostheses and decreased chairtime for the clinical procedures. The benefits and limitations of this treatment protocol are also discussed.