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In recent years, the use of immediately loaded implants became more acceptable as a standard protocol for completely edentulous lower jaw and/or partially edentulous upper jaw cases, predominantly in the anterior region, after it was one of the cornerstones of the early protocols to avoid any occlusal loading of the implants for at least 3 months. This technique could potentially provide immediate function and aesthetics to the patient. This review aims to present the clinical indications of the immediately loaded protocol according to the individual cases and the corresponding risk factors and contraindications. The clinical, biomechanical and biological requirements concerning bone quality, occlusal loading and implant primary stability are discussed. Primary stability in immediate loading is determined rather by surgical than biological parameters. Peri-implant osteogenesis leading to secondary stability depends on the same biological factors than in unloaded implant healing. However, specific mechanical effects on the biology of immediate loading osseointegration are yet to be investigated.

Clinical, biomechanical and biological aspects of immediately loaded dental implants: a critical review of the literature