Rethinking immediate dental implant loading

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“We are not selling implants”—rethinking immediate dental implant loading


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Clinical application of the Osstell ISQ SmartPeg in order to measure implant stability. (Image: Mauro Labanca)
Franziska Beier, Dental Tribune International

Franziska Beier, Dental Tribune International

Mon. 1. March 2021


Immediate loading is increasingly being offered as a routine method in dental implant surgery. However, according to Dr Mauro Labanca, it should be handled with more caution, as research has demonstrated that its success rates do not always match those of traditional methods. In an upcoming free webinar on 10 March, he will explain how to ensure qualitative care while applying scientifically proven tools which enable clinicians to obtain objective data on implant stability that is comparable over time.

Dr Labanca, more and more general dental professionals are performing dental implant therapies, and treatment times and healing times are increasingly being reduced. In your opinion, are we moving backwards rather than forwards in dental implantology?
You have pointed out a very important issue. My feeling is that we are facing a time in society in which we expect to receive everything we need immediately. Patients and dentists imagine that biology can also follow these rules. This is, of course, a huge mistake, which quite often results in failure. Too often, I hear proposals that are more about marketing rather than medicine. We must go back to the fact that we offer clinical solutions; we are not selling implants! And if we have to wait a little bit longer for a better long-term result, this better result will always justify our decision.

Dr Mauro Labanca has practised oral surgery and implantology since 1992 in his private dental office located in Milan in Italy. (Image: Mauro Labanca)

In an editorial in 2020, you stated that many claims for new products or methods in dental implantology lack sufficient scientific support. Is this also true for immediate loading?
Absolutely, yes. In the past, we were used to waiting a long time to obtain results that were truly based on evidence. Now, we are moving to adopt new clinical procedures or new products too fast and not taking the required time to verify their long-term reliability.

How can dental professionals ensure good quality and the best outcome in implant treatments as well as applyas you put it in your webinar descriptionconscience?
Too often I see that colleagues, regardless of their age, are more interested in being appealing, in suggesting the most updated solution, or in accepting what patients ask for, rather than in being medical professionals with the sole intention of finding the best solution together with the patient. I remember clearly that, when I taught about evidence-based dentistry, we moved quite quickly from this concept to the concept of patient-oriented evidence that matters (POEMS). This is what we always have to consider: patients need appropriate solutions.

In your webinar, you will also speak about implant stability quotient (ISQ) measurement and resonance frequency analysis by Osstell. How can these tools support dental professionals in the decision-making process?
Surprisingly, we still consider ISQ measurement as a new tool! It is such an old concept and has been well studied and validated for many years and documented in numerous articles. It is an indispensable method of objectively evaluating the primary stability of the implant, the most important parameter of success. It helps the dentist to make the right decisions about surgical procedures and the timing of postoperative procedures. In addition, it is very useful in explaining to the patient what we do and why. Despite the fact that we do have this great tool, and the fact that many clinicians propose immediate post-extraction implants or immediate loading, these systems are still available in too few practices.

Editorial note: The webinar, titled “Immediacy: Always properly performed?”, will be presented live on Wednesday, 10 March, at 1 p.m. CET. Participants will have the opportunity to ask questions about the topic upon completion and to earn a continuing education credit. Registration on the Osstell Campus website is free of charge.

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