Back when I first started placing implants (1998) we were waiting 6 months on the maxilla and 4 months on the mandible before restoring. I’m wondering what the consensus is today and what everyone is doing as far as waiting period? Also do you differentiate for immediate placement vs non immediate? Thanks for your input
Today, I use the initial torque reading (35ncm) and ISQ reading (70plus) as my criteria to immediately restore an implant with a temporary. The temporary crown(s) are out of occlusion and function for 3 months. If I do not restore for any reason at implant placement, I perform the ISQ reading at 3 months regardless of arch when I’m ready to restore. I do not do a reverse torque reading at this time; if the implant moves when removing the healing abutment or surgical healing cap, I wait another 2 months before repeating the same protocol.
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I also wait 3 months ( a bone turnover cycle in humans), and do an ISQ at placement and at integration evaluation. With immediate placement I’m engaging cortical bone of the socket so stability is typically solid. I don’t do many non-functional temp crowns at implant placement. I don’t like retreating anything I can avoid.
Having had multiple ISQ devices accumulate in my closet I have resorted to good old fashion 10-12 weeks of healing regardless of initial torque. My experience has demonstrated that initial torque value is just that, initial torque value. ISQ is just another objective value with no real bearing on future success but can really help ease the mind. At the end of the day I place 30Ncm of torque on the fixture at the 10-12 week point and give it a tap. If it pings and it don’t spin then it is a winner… This is how I approach it and I am in no way suggesting that I am right and others are wrong.