Those who suffer from repeated inflammation or are not satisfied with the look of their mouth, dream of clicking a button and replacing their teeth with healthier, better looking teeth, in a single day.
This fantasy is the basis to many adverts that flood mainstream media, promising to turn the dream of one-day transplants to a reality.
Patients are unable to properly determine whether or not these promises are genuine, and address their physicians with this question. The doctors are then pressured by the public demand for quick and easy solutions. Commercial dental companies also contribute to this pressure and invest greatly in Research and Development of this field.
To properly understand the possibilities of transplants in one day, some facts need to be addressed:
The graft is inactive throughout the entire time until it combines with the jaw bone (3-6 months). Therefore, temporary teeth are necessary during this time period to ensure the patient enjoys function and an aesthetic appearance (especially true for frontal teeth). Normally, temporary prosthetics are used and these aren’t always comfortable, so patience is required until the grafts are exposed and the final procedures are executed.
In many cases, the insertion of a dental graft is accompanied by a bone transplant to strengthen and reconstruct the jaw bone. Sometimes, the doctor needs to thicken the tissues by soft-tissue transplant. These treatments require a longer healing period which is crucial to their success.
Transplants are a key service in many dental clinics; therefore, there is an ongoing race to find a “quick fix” in which the patient could finish the treatment with temporary-yet-steady teeth, immediately after the grafts have been placed.
This method is called “Immediate Loading”. Temporary crowns are used right after the grafts are placed – no waiting necessary – and this is how the marketing message “Transplants in One Day” came to be. On the same day, the doctor will pull the lost teeth, plant the grafts and install temporary crowns, rather than a prosthetic.
Research and experience have shown that this method is quite successful, with a success rate of 60-80%. However, this is still lower than the conventional method.
It is a sensitive technique that requires a combination of several conditions before it is a relevant option for the patient:
1. Considerable bone mass: Bone height and width are necessary, but this isn’t always the case when pulling numerous teeth as a result of infection and inflammation. Meaning, patients whom are nominated for bone transplants and sinus floor lifting are not suitable candidates for Immediate Loading.
2. Bone quality: Density is preferred (this can be evaluated by CT scan).
It should be noted that older patients tend to suffer from Osteoporosis and therefore aren’t always suitable candidates for Immediate Loading.
3. Using particularly long grafts to achieve initial stability is necessary for Immediate Loading. This condition is an obstacle in cases where bone height is lacking.
4. It is recommended that special Immediate Loading grafts are used for this procedure. These grafts have a good anchoring ability (insertion force up to 35N, for at least1 centimeter).
The rough surface of the titanium encourages a faster biological bonding with the bone cells, yet the roughness in itself may cause bacterial adhesion and future infections.
5. No bruxism (grinding): Strain and stress on the jaw muscles. A significant portion of the general public suffers from grinding of the teeth.
6. No risk factors such as heavy smoking which can cause rejection of the graft due to lower blood supplies, or unbalanced diabetes which interferes with healing.
7. Balanced bite to distribute loads and forces harmoniously and minimally over each graft.
8. Immediate Loading of the entire jaw is preferred to loading of single grafts (harder to balance).
9. Combining surgical and rehabilitative treatment is a challenge, as the surgeon can’t always perform good rehabilitation, and vise versa. Time is a key factor in receiving a good aesthetic result – something which may be harder to achieve after a long surgical process. Therefore, there is often a compromise.
10. Changing eating habits. Soft foods are to be consumed for at least a month and a half after Immediate Loading.
There are further challenges and conditions, but if the patient is a suitable candidate and is interested in Immediate Loading, he or she must take into consideration all of the possible repercussions compared to the conventional method.
To conclude, the Immediate Loading method enables installing temporary steady teeth on the day of the transplant. It is a challenge both for the dentist and for the surgeon, and requires careful case selection according to known criteria. This method requires knowledge, skill, experience and control over many fields in dentistry (surgical and rehabilitative). It is in no way an ordinary procedue, and must be studied accordingly.
Patients ought to be cautious about adverts promising false services such as transplants in one day, without surgery, as every transplant is a surgical procedure!
Our best recommendation is to get a second opinion from an experience physician in the field of transplants, whom is up to date on all of the recent technologies.
Navigation systems are also preferred (grafts are placed in a safer, more accurate manner) and remember: if it sounds too good to be true – it probably is!