Edentulous Half-Arch Immediate Loading: Preoperative Assessment and Surgical Documentation

2026-04-21

II. Preoperative Assessment Content

Preoperative assessment constitutes a critical component of immediate loading procedures.

2.1 Systemic Condition Screening

The following conditions require exclusion or additional evaluation:

Uncontrolled diabetes mellitus
Severe osteoporosis
Immunodeficiency
Coagulation disorders

Medication-related considerations:

Long-term bisphosphonate use: evaluation of osteonecrosis of the jaw risk required
Long-term anticoagulant use: evaluation of bleeding risk required

2.2 Local Bone Condition Assessment (CBCT Measurement)

CBCT measurement includes:

Mandibular bone height, width, and density
Positional relationships of the mandibular canal, mental foramen, and other anatomical structures

Bone density characteristics:

Mandibular body bone density is generally higher than the maxilla
Patients with poor bone conditions (severe bone resorption, low bone density) require focused evaluation

III. Surgical Procedure Documentation

3.1 Mental Foramen Region Management

Exposure of the mental foramen
Visualization and protection of the mental nerve

3.2 Knife-Edge Alveolar Ridge Contouring

Utilization of knife-edge alveolar ridge trimming bur
Formation of a flat bone platform

3.3 Osteotomy and Implant Placement

Sequential drilling protocol
Implant insertion

3.4 Multi-Unit Abutment Placement and Suturing

Multi-unit abutment utilization for angle correction
Healing cap placement
Tension-free suturing

IV. Review Points for Patients with Prior External All-on-4 Surgery

For patients with poor bone conditions who have undergone All-on-4 surgery at external facilities, review content includes:

Bone remodeling status
Implant positioning
Nerve injury risk assessment
Verification of original implant angulation
Multi-unit abutment compatibility
Neurological symptom evaluation (lower lip numbness, pain, etc.)

V. Technical Positioning

The selection and implementation of edentulous implant restoration protocols involve the integrated application of technical knowledge and clinical experience. Immediate loading is a technical procedure conducted on the basis of comprehensive assessment and strict adherence to indications.