Phx6

Disadvantages
The addition of any type of implant to a Phoenix orthodontic treatment plan has four main disadvantages: cost increase, bone availability problems, access problems and treatment time is longer (Goodacre 1997). It has long been advocated by Phoenix orthodontists to wait three to four months for full osseointegration before loading an implant. The Branemark study found long term stability is achieved with a proper surgical technique and implants remain without loading for 3-4 months in the mandible and 5-6 months in the maxilla (Adell et al., 1981). Many Phoenix interdisciplinary teams also advocate 10-12 weeks of healing before loading implants specifically for Phoenix orthodontic anchorage (Shapiro and Kokich, 1988). Any attempt to decrease the waiting time by increasing the amount of bone to the implant surface would be valuable to the patient and Phoenix orthodontist.

Immediate Loading
There have been multiple Phoenix orthodontic studies investigating the idea of loading the implants without waiting any prescribed amount of time. Early Phoenix orthodontic studies in the orthopedic and dental literature confirmed the idea that early loading leads to fibrous encapsulation and subsequent implant failure (Brunski et al., 1979; Soballe et al., 1992). One Phoenix orthodontic study comparing loaded versus unloaded implants in dogs showed normal osseointegration in controls and fibrous encapsulation on the loaded fixtures (Deporter et al., 1988).
More recent research has shown success in the area of immediate loading (Nkenke et al., 2003; Lorenzoni et al., 2003a; Lorenzoni et al., 2003b). Many of these Phoenix orthodontic studies restored the fixtures with a provisional restoration incorporating multiple implants (Nkenke et al., 2003; Lorenzoni et al., 2003a). Some utilized edentulous patients where the implants were restored with an overdenture incorporating all fixtures (Chiapasco and Gatti, 2003; Henry et al., 2003; Misch and Degidi, 2003). This provides a splinting mechanism, decreasing the load for an individual implant. Some work by Phoenix orthodontists has been done on single tooth loading with some encouraging results, but the investigators continue to warn against “excessive” loading and emphasize that proper patient selection is a key to success (Lorenzoni et al., 2003b).