- The knowledge of osseointegration biology allowed the establishment of clinical criteria to obtain valid results for the implantologist and for the patient. This knowledge finally result in several consensus (Weber et al. 2009) where they tried to classify the loading times, so that Aparício and col., in 2002, established the following criteria (Aparicio, Rangert, and Sennerby 2003):
- Immediate loading: implants are loaded on the same day of surgery.
- Early loading: implants are loaded before the conventional loading, classically established as 3-6 months after surgery.
- Conventional Loading: implants are loaded 3-6 months after surgery.
- Delayed loading: implants are loaded later than 3-6 months after surgery.
During the third ITI Consensus Conference, at Gstaad (Switzerland), in 2003, the concepts evolved:- Immediate loading: implants are loaded until 48 hours after surgery. This prostheses has occlusal contacts.
- Early loading: implants are loaded after 48 hours and before the 3 months after surgery. This prostheses has occlusal contacts.
- Conventional Loading: implants are loaded 3-6 months after surgery.
- Delayed loading: implants are loaded later than 3-6 months after surgery.
- Immediate loading: implants are loaded until 48 hours after surgery. This prostheses has occlusal contacts.
- Immediate restoration: implants are loaded until 48 hours after surgery, but without occlusal contacts.
According to the EAO (European Association for Osseointegration) classification, established in 2006 (Nkenke and Fenner 2006a):
- Immediate loading: implants are loaded until 72 hours after surgery. This prostheses has occlusal contacts.
- Conventional Loading: implants are loaded 3 months (jaw) and 6 months (maxilla) after surgery.
- Non-functional immediate loading: implants are loaded until 72 hours after surgery, but without occlusal contacts.
According to the Cochrane classification, that is based on several sistematic literature reviews (Esposito et al. 2008):
- Immediate loading: implants are loaded until one week after surgery. It doesn’t differentiate between with occlusal contacts and without.
- Early loading: implants are loaded after one week and before 2 months after surgery.
Conventional Loading: implants are loaded later than 2 months after surgery.
It is worth noting that the classification published by Cochrane (Esposito et al. 2008) doesn’t differ between immediate provisionalization and immediate loading, considering the pressure made by lips, tongue and bolus act like “pseudo-loads” (Touati and Guez 2002) that might interfere with implant’s osseointegration despite not having occlusal contacts (De Rouck, Collys, and Cosyn 2008). Other authors, however, compared immediate loading with immediate provisionalization of anterior maxillary unitary implants, finding similar results on both cases (Lindeboom et al. 2006).
