Definition and objectives

In the majority of clinical situations, it is necessary to wait 2 to 4 months before fixing a prosthesis to an implant. This is the time needed to obtain osteointegration. To achieve this bone integration, the implant must not be mobilised during this critical period, as otherwise the procedure may fail.

Nevertheless, in some favourable cases, it is possible to fix a temporary prosthesis to the implant very soon after surgery. This is called ‘immediate management’.

The objective of immediate management is not so much to be able to chew using the temporary prosthesis but for immediate comfort and to avoid wearing an unstable immobile prosthesis during the implant healing period.

Immediate management techniques are specific surgical techniques which save time while retaining the same success rate.

The operation

The risk attached to the immediate management method is mobilisation of the implant and not obtaining osteointegration. This technique is therefore only applied in certain conditions.

Two clinical situations are particularly suited to immediate management:

- The case of front teeth

When a front tooth is replaced and bone conditions permit, it is possible to place a temporary tooth on the implant immediately. The implant has to have excellent stability when it is inserted.

The advantage is that the patient does not have to wear a temporary immobile prosthesis or temporary bridge during the implant osteointegration period.

As the implant is not attached, it is important not to bite on the temporary tooth for 2 to 4 months. This is why the prosthetic tooth is sometimes slightly smaller, to avoid any contact with opposing teeth.

- The case of total edentation (treated with fixed bridges)

Treatment of total edentation requires insertion of 4 to 6 implants depending on the clinical situation. In some favourable cases, and if the implant is very stable an mould can be taken at the end of the operation.

The aim is to insert a temporary fixed bridge 24 to 72 hours after the operation.

Once the bridge is in place, it is imperative not to exert an substantial force on it for 2 to 4 months.

Chewing food is therefore contraindicated (meat, bread…) and it is advisable to eat soft food (vegetables, pasta, mince meat, fish, mashed fruit). This advice must be adhered to scrupulously.