When to Restore IBS Implants?

Dr. Pond, who is speaking in Santa Fe, asked Dr Wang the following questions:

"I have some specific questions that I'm hoping Dr. Wang could answer for me.
When doing PBR":

When doing PBR:
Bone Q1= immediate loading
Bone Q2= early loading
Bone Q2E= wait 4 months?
Bone Q3= wait 4 months?
Bone Q3E= progressive loading
Bone Q4= progressive loading 
1. Is each "Bone Quality" time above correct?
2. What does Dr. Wang mean by;
       "early loading"?
       "progressive loading”?
…………………………………………………...
Dr Wangs answer;
Q1 = Immediate Loading Possible 

Q2 = Early Loading (less than 3 months)

Q2E = “Delayed” Loading (4~5 months) (Due to requirement of bone grafting)

Q3 = “Delayed” Loading (4~5 months) (No bone grafting, but formation of placement hole is possible with magic  expander)

Q3E = “Delayed” Loading (More than 8 months) (Due to very little cortical bone and lots of bone marrow space. Bone grafting is required)

Q4 = “Delayed” Loading (More than 8 months) (No cortical bone)

 “Early Loading” refers to the ability to successfully load within 3 months of placement. This is possible in a lot of cases with Q2 bone because the Magic Fin Thread maximizes the preservation of the patient’s original bone during placement. 

 “Progressive Loading” is the concept introduced by Dr. Karl Misch, in which the bone around the implant is loaded with progressively higher loads in order to strengthen the bone’s resistance to forces. Dr. Wang says that theoretically, Q2E~Q4 is supposed to be progressively loaded. And the concept of progressive loading is theoretically sound BUT completely impractical due to the fact that the oral habits of patients cannot be controlled by the clinician. Progressive loading’s success is contingent upon careful control of the patient’s oral and chewing habits. Thus, the concept of the IBS system is to maximize the preservation of the patient’s original bone because of the fact that original bone has much higher resistance to loads, and ultimately, a better initial loading capability of the bone. 

Immediate implant is conducted immediately after extraction with limited amount of bone, usually apically.  It can be immediately loaded with a provisional (temporary restoration) without centric or noncentric occlusal contact initially (more or less Progressive loading).  What Dr. Wang routine does is to extract a tooth, let it heal with formation of (cortical) bone in the socket and place an implant.  If the bone is dense, the implant placed could be immediately loaded with a temporary or permanent crown.

Return to IBS

Xin Wei, DDS, PhD, MS 1st edition 08/03/2016, last revision 01/19/2018