Loading Protocols

The immediate loading of the implants is ideally a desired situation.

In clinical situation where this ideal cannot be ensured different loading protocols are applied with OCTO implants, stated as follows

OCTO implant can be loaded immediately when clinical conditions are eligible. After the implant placement, parallelism can be obtained easily by angled or straight abutments and by virtue of their morse taper characteristic that can rotate 360 degrees. When immediate provisional fixed restoration is made, the conventional methods are used. The permenant restoration procedures are completed also using the known conventional clinical methods for fixed restorations. It is known that the clinical success rates obtained by the immediate loading are similar to the success rates of the conventional loading when the necessary conditions are provided.

Case Selection in Immediate Loading

• The patients with good oral hygiene and cooperation
• The patients without bruxism and having good occlusal relationship
• The patients without acute purulent and large apical lesion
• The patients with higher bone volume and densities
• The cases in which labial bone wall and socket are protected during and after the tooth extraction
• The cases having bone in amount that will stabilize the implant that can move to the apical to the socket after the tooth extraction.
• The cases with gap less than 1 mm between the socket and implant
• The cases which take support from the palatinal and lingual cortical plate
• The cases in which implants will be sufficient in size and number according to the patient force factor • Patients with appropriate systemic health

Immediate or early loading with single-phase surgery

The following conditions are necessary for immediate loading

• Higher primary stability: The primary stability of the implants also demonstrate variability depending on the different bone densities and osteotomy methods. The implant should be inserted in its final position with a mean of 30 to 35-Newton per cm torque within the bone.
• The regulation of the loading factors: the clinical factors (vertical and horizontal cantilever, non-axial forces, bruxism, and occlusal imbalance) that provide load increase on the implant should be minimized.
• Implant with increased bone contact surface: OCTO implants macro geometrically designed square threads will increase primary stability and bone contact in type 3 and type 4 bone. Also, its micro geometrically designed rough surface structure will stimulate bone cells and bone growth over the implant.

Late loading with Single-Phase Surgery

In single-phase surgery, the healing abutments placed on the implants left uncovered during the osseointegration period. The mean healing time for late loading is approximately two months for the lower jaw and approximately three months for the upper jaw. The use of the proper healing abutment after inserting the implant is recommended for the health of bone,gingiva and for better esthetics. 2-, 3- and 5-mm height healing caps are selected in the single-phase surgery according to the height of the gingiva.

Late loading with Two-Phase Surgery

In the two-phase surgical method, the healing abutments placed on the implants submerged and are completely covered with gingiva during the osseointegration period. it is ensured to protect the implants from the functional loads by leaving them under the soft tissue. This method requires a second surgical phase to uncover the implant located under the soft tissue differently from the single-phase surgical method. After uncovering of the implant, a taller healing cap is placed in to the implant after removing the 0.5mm short healing cap under the soft tissue. When an abutment is placed instead of higher healing cap, a provisional fixed restoration should be placed immediately on the abutment to obtain a proper emerging profile and to prevent the soft tissue collapse around the implant crestal region.

When two-phase surgery is applied in the OCTO implant system healing cap with 0.5-mm height (located on the cover of the implant box) are used to close the gingiva completely. In two-phase surgery, it is recommended to insert the implant 0.5 mm below the crestal bone level.

In some cases with thin soft tissue and gingiva phenotype OCTO implants should be inserted 1 mm under the bone level.