Short answer
With full-arch immediate loading, a fixed resin interim prosthesis, screw-retained on the implants, goes into function within a week of surgery, the window that defines immediate loading in the ITI consensus. To work inside it, we need the surgery date agreed in advance, the abutments used, a bite registration and a tooth-position reference.
What it is
The fixed interim prosthesis that goes in right after implant placement in an edentulous arch, or one that has just lost its remaining teeth. It is a full-arch PMMA piece, screw-retained on multi-unit abutments, that stays in function through osseointegration.
The 2018 ITI consensus defines immediate loading as a prosthesis connected in occlusion within one week of surgery. For edentulous jaws, the ITI consensus considers immediate loading with a one-piece fixed interim prosthesis as predictable as early or conventional loading, in both the maxilla and the mandible.
When to prescribe it
The indication is surgical and it is yours: primary stability of each implant, number and distribution of implants, and whether grafting is done at the same time. On the lab side, what matters is the calendar. The prosthesis has to be ready inside the one-week window, so the surgery date goes on the prescription first.
The interim is also the rehearsal for the definitive. Tooth position, vertical dimension and phonetics tested in it become the basis for the full-arch zirconia bridge or the PMMA full-arch bridge that follows. Our article immediate loading: what the lab needs walks through that sequence.
How we make it
Smile Digital Lab makes immediate-load prostheses in-house in São Paulo, Brazil, with an integrated digital workflow from file to delivery. Inside a one-week window, what matters is no surprises: every stage of your case is validated and logged, the prosthesis goes through eight checks before it ships, and you follow its phase in the portal up to the day of delivery.
What to send
What you send depends on your surgical workflow. In a conventional workflow, you scan the scan bodies or take an impression with impression copings right after surgery, and the prosthesis is designed from that record. With guided surgery, the literature describes an interim designed from the plan, milled ahead of time and picked up on the copings in the mouth. Which route your case takes (a new interim, a conversion of the current denture, or a prosthesis ready before surgery) is agreed when the case is opened, along with the date.
The basics are in our case submission guide. For immediate loading, pay attention to the bite registration: once the teeth are out, the reference for vertical dimension is gone. Record the bite with the current denture in place, or send the approved setup before surgery.
Frequently asked questions
What is the turnaround for an immediate-load case?
Under the 2018 ITI consensus, immediate loading means the prosthesis is in occlusion within one week of implant placement. The case turnaround is agreed at check-in, working back from the surgery date. Tell us early, so the delivery date is on the order before surgery.
Can I convert the patient's denture instead?
The clinical call is yours, and the lab route is agreed when the case is opened. In an in vitro study in The Journal of Prosthetic Dentistry, the holes cut to pick up the copings weakened converted dentures, and milled PMMA showed 35% higher flexural strength than heat-processed denture base acrylic.
Can the provisional be ready before surgery?
With guided surgery, the literature describes that route: the provisional is designed and milled from the plan, then picked up on the copings in the mouth. In a 10-patient study, provisionals made this way seated without enlarging the access holes and lasted a year with no fractures. If that is your workflow, we'll confirm it with you when the case is opened; send the plan and the guide.
When is immediate loading not recommended?
The surgeon decides. The ITI consensus treats primary stability as critical and lists simultaneous bone augmentation or sinus elevation as a relative contraindication to immediate loading.
Sources
- Implant placement and loading protocols (consensus statement, 2018) · ITI Academy
- Loading protocols for fixed prostheses in edentulous jaws (consensus statement) · ITI Academy
- Comparison of strength of milled and conventionally processed PMMA complete-arch implant-supported immediate interim fixed dental prostheses · The Journal of Prosthetic Dentistry (2023)
- Computer-assisted implant placement and full-arch immediate loading with digitally prefabricated provisional prostheses without cast: a prospective pilot cohort study · International Journal of Implant Dentistry (2021)