Immediate or Delayed Loading of Implant?

Dr S If you are confusing immediate loading with immediate temporization, I can see a reason for your question. Otherwise, I think you are placing implants without a firm grasp of some basic concepts of implantology. Immediate loading is usually reserved for full arch bilateraly stabilized fixed cases. When single units are immediately temporized, they are not loaded immediately, instead they are protected from occlusal load during the osseointegration period. I question the need or reason to immediately temporize a first molar. Considering the size of the molar and the softer quality of the bone in the maxillary first molar area, a 5X13 implant would have been more appropiate, and the appropiate time to load would be anytime after 4 months if it had good stability at the time of placement. Good luck,

I will often use a Periotest-M (Salvin Dental) to help determine when the implant is ready. You don't want to have an expensive custom abutment and crown "ready to go" an get a spinner (implant that rotates) as you torque down your abutment. Because at that point you would have to wait another 6 months and you lost your custom abutment and crown. I would error on the conservative side and wait a full 6 months.

I would have used a wider diameter implant, submerged it to the level of the bone if I could and placed some form of bone material to full in the defect in the coronal osteotomy. And then forgotten it for 6 months. If this was the lower first molar region it could have been loaded after 4 but its definitely without a doubt better to wait then to hurry loading this. I wonder where you placed this implant?

I have found the periotest to be completely unreliable

Re: a 5 x 13mm implant is better. Wider implant could most likely have been used ( however I don't have a radiograph to back this advice up) As for longer - why, not much difference in survival going over 10mm (now even 8mm with todays newer surfaces) Please correct me if I am wrong. As for the temporary - its a molar, who cares.

planning is one of the important point regarding implant success.during planning we decide when to place the implant & when to load it. you decided to do immediate implantation in posterior maxilla, it means the reason for the extraction was not infected tooth,but you mention fractured one ,is it because of non crowened endo treated tooth?ortraumatic occlusion. did you need bone graft or not/how was your primary stability. if you have achive a good one.then your case is not an indication for immmediate loading which equal immediate failuer

Periotest is unreliable. Don't waste your time. I do a lot of immedite load and temporization cases. This is one I wouldn't do either on. Leave it alone for 4-6 months.