Immediate Loading with Fixed Screw-Retained Provisional Restorations in Edentulous Jaws: The Pickup Technique

Purpose: This article describes (a) an immediate loading technique in the treatment of edentulous arches with screw-retained provisional restorations and (b) the effort to determine whether the described technique is compatible with the predictable achievement of osseointegration. Materials and Methods: Eight patients with either 1 or 2 edentulous arches were treated. A diagnostic tooth arrangement was carried out for each patient and was then duplicated twice to fabricate a provisional template and a surgical guide. Six to 10 solid-screw ITI implants were placed around the dental arch to reach the first molar regions. On the same day, all patients received splinted metal-free screw-retained provisional restorations according to the pickup technique. The provisional prostheses were retrieved every 2 weeks during the healing phase. Results: Seventy-eight implants were placed in 11 edentulous arches. Two implants were not immediately loaded because of inadequate primary stability. In an 8- to 20-month follow-up period (mean 14 months), two 8-mm implants were lost after 5 weeks of functional loading, resulting in an overall survival rate of 97.4%. All implants were assessed by resonance frequency analysis. After 4 months of functional loading, the mean implant stability quotient was 60 ± 4.1 units (range 51 to 72 ISQ units) for maxillary implants and 65 ± 6.5 units (range 47 to 74 ISQ units) for mandibular implants. Discussion and Conclusion: The immediate loading of implants placed in edentulous arches with screw-retained 1-piece (cross-arch) provisional restorations does not appear to jeopardize the achievement of osseointegration. Neither the metal-free design of the provisional prostheses nor the removal of the provisional prostheses during the healing phase adversely affected osseointegration. The pickup technique for immediate provisionalization represents a reproducible treatment option.