Is it possible to have fixed teeth on the same day?

Immediate loading is an established procedure, practised for decades and widely documented. In full-arch rehabilitations in the atrophic maxilla, it is the outcome the planning aims for from the outset — and not something left to chance.

In full-arch rehabilitations: why it is the norm

The determining factor is primary stability: the degree of fixation the implant obtains in the bone at the moment it is placed.

The concept rests on the possibility of anchoring the implants in dense bony structures: palatal anchorage, the zygomatic, pterygoid and transnasal approaches, and angled implants with bicortical engagement. It is no coincidence that these techniques allow immediate loading — it is the reason we use them.

The scientific evidence supports this option, both with conventional implants and with zygomatic anchorage. A systematic review that brought together 5,954 implants in 1,294 patients and 1,305 fixed full-arch rehabilitations found survival of between 95% and 100% across all loading protocols, including immediate loading ^[1]. In rehabilitations with zygomatic implants, the ITI consensus report found that immediate loading showed a statistically higher survival than delayed loading ^[2]. Waiting is not, in these cases, the safer alternative.

Correct planning of these cases is what gives us predictability: it makes it possible to obtain the initial stability needed to place the provisional prosthesis on the same day. That prosthesis restores appearance and function during the initial phase of implant integration, and is replaced by the definitive prosthesis after healing and the integration of the implants and the tissues.

In the replacement of a single tooth

When a tooth is extracted, it is possible, in certain situations, to place the implant in the same surgical procedure and to fit a provisional fixed tooth over it. Feasibility depends on the stability obtained in the remaining bone and on the condition of the surrounding tissues.

There is a relevant difference here compared with full-arch rehabilitation. The provisional tooth placed in these situations is usually adjusted so that it does not receive contacts during chewing: it restores appearance and comfort from the first day, without subjecting the implant to functional loading while it integrates.

When bone regeneration is involved, the healing times take precedence and the rehabilitation takes place after integration.