Immediate Loading of Mandibular Overdentures

Immediate loading of mandibular overdentures is indicated for patients with a physical or psychological intolerance of conventional removable prostheses (dentures); this type of treatment also overcomes the problem of the edentulous period following implant placement. Immediate loading of mandibular implant-supported overdentures is a highly predictable treatment that patients are requesting with increasing frequency as it avoids wearing a removable denture (without retention). Correct patient selection and treatment planning are essential to ensure treatment success, as well as close collaboration between dentist and prosthetics laboratory, as the procedure requires exact timing. The ideal treatment protocol involves four intermentonian implants (as the intermentonian area offers excellent bone quality, facilitating primary stability), splinted by a retention bar to eliminate micromovement. The implants must be at least 10 mm long with a surface treatment that will maximize primary stability and reduce the time required for osseointegration. The recommended follow-up period is 24 months after implant placement and should consist of clinical and radiological check-ups of the implants, retention bar, and overdenture. Treatment outcomes are comparable to conventional loading protocols and enjoy success rates close to 100% over a 5-year follow-up. To sum up, satisfactory osseointegration will make immediately loaded mandibular overdentures a predictable therapeutic technique; this depends on an adequate diagnostic protocol, accompanied by correct surgical and prosthodontic procedures, followed by a long-term maintenance protocol.