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Immediate Loading and Cross-Arch Stabilization

Several years ago there was some controversy among dental professionals about dental implants, immediate loading, and cross-arch stabilization in a full mouth restoration. As technology changes and research is conducted, dental methods will continue to change. Often, those changes can be uncomfortable or scary to a dentist who might not be in step with current methods. So, what is delayed loading, immediate loading, and cross-arch stabilization, and why does it matter? 


What Patients Should Know about Delayed Loading 


A brand-new implant in a patient’s mouth needs time to heal, and often a dentist might leave the implant without a tooth on it for many weeks. This is called delayed loading. This method prevents the implant from receiving any pressures during healing. In this scenario, the implant would heal for a few months before adding the crown or tooth to it. While sometimes this may be the only option, there are a few drawbacks to delayed loading:  


  1. Prolonged Treatment Timeline: Delayed loading can require more visits over a longer time before the patient has a fully restored tooth. 

  1. Functional Limitations: The patient is without a tooth in the area for multiple months which can have negative psychological and functional impacts. 

  1. Additional Costs: Sometimes there can be additional costs for delayed loading including creating a temporary “flipper” to cover the site of the missing tooth. 

  1. Disruptive Healing: The tissue near the implant site heals without the tooth and usually has to be cut open again to access the abutment for placing the crown. This means a longer healing period and that the tissue may not form as naturally against the tooth. 


Implant placed with delayed loading and no crown
Implant placed with delayed loading

Benefits of Immediate Loading 


Immediate loading means securing a tooth or teeth on the dental implant immediately after placing the implant. The immediate tooth or teeth can be a permanent restoration or only temporary. An immediately loaded tooth should still not take on full biting pressures, but will receive some small pressures during healing to improve outcomes. More and more dentists are finding that when appropriate, immediate loading providers better outcomes. Some of the reasons that many dentists prefer immediate loading include: 


  1. Improved Healing: With immediate loading, the implant site is only disturbed once, on the day of surgery. 

  1. Improved Esthetics: As the tissue heals, it will heal to the shape of the tooth, making the final outcome look more natural and beautiful. 

  1. Bone Stimulation: Research is showing that having small amounts of stimulation during the healing process can create improved outcomes and help preserve bone levels. 


immediate load implant
An implant receiving immediate loading with a crown

It is important to remember that there are tradeoffs. If a patient has poor compliance with instructions such as following the dietary restrictions during healing, an immediately loaded implant will be at a greater risk of failing. 


What is Cross-arch Stabilization? 


When replacing a full arch of teeth, your dentist may refer to “cross-arch stabilization.” This is a term to describe a process of protecting implants by placing a fully connected arch of teeth in the mouth. By so doing, the full arch equally distributes the pressures across the entire prosthetic, not allowing focused pressures on any given implant. Almost all dentists today utilize this method to protect full arch implants during osseointegration (the healing phase of the implants to the bone). 


Cross-arch stabilization with 3 on 6 dental implants
Full arch of teeth providing cross-arch stabilization

While cross-arch stabilization is great at protecting implants from pressures, this benefit can become a detriment after the implants have healed. Cross-arch stabilization is like putting a broken arm in a cast; it protects the bone from excessive strain while it heals. When a broken arm is healed, we remove the cast so that the arm can be used, exercised, and return to full strength. Leaving the arm in the cast would cause harm to the limb. 


Unfortunately, many dental prosthetics will leave the patient’s mouth in this restricted state, reducing the natural pressures that the implants and bone need to stay healthy. This leads to bone loss which can create other problems such as visible gaps, food traps, and failed implants. 


Improving Implant and Bone Health with 3 on 6™ 


With the 3 on 6™ full arch treatment, the patient receives their implants and a full arch of teeth on the day of surgery. This provides the cross-arch stabilization to help the implants heal properly. After three months, the patient’s implants are fully healed and their full arch of teeth are replaced with three segmented bridges.  


3 on 6™ dental implants with segmented bridges
3 on 6™ with segmented bridges

With segmented bridges, there is no longer cross-arch stabilization and the implants and bone start taking on normal chewing pressures. This progression from protecting the bone from pressure to allowing to to receive pressure is critical for the implants and bone health. This is one of many reasons why the 3 on 6™ has longer lasting, more predictable results for full mouth restorations. Radiographic imaging has shown bone preservation and even bone growth in 3 on 6™ patients even years after their surgery. 


To learn more about immediate loading, cross-arch stabilization, and the 3 on 6™ procedure, you can visit a 3 on 6™ authorized provider and receive a free consultation.

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