After an in-depth excursus on the evolution of the “immediate loading” concept in modern implantology, the author uses an interesting clinical case of partial edentulism in the mandibular latero-posterior sector to present the surgical and prosthetic phase of a Toronto Bridge screwed prosthesis, with control after 4 years. It shows the absolute stability of the hard and soft tissues and the patient’s complete satisfaction with the aesthetic and functional outcome. It can be concluded that this therapeutic approach has psychological and social advantages. The patient’s sacrifice to concentrate the surgical and prosthetic procedures in a short period of time is well rewarded by the possibility to immediately benefit from a provisional prosthesis whose level of comfort is similar to that of a final prosthesis. In addition, the provisional prosthesis supported by the bar protects the wound during the post-surgical phase allowing the soft tissues to heal better.
There are some advantages in using this same bar, which was created for immediate loading with removable overdenture to be used as a structure to support a screwed prosthesis: during the healing phase, the margins of the prosthesis can be corrected by following the remodelling of the hard and soft tissues, the patient’s final choice between a fixed or removable prosthesis occurs after a testing period during which they can evaluate the qualities of each solution, as well as the already mentioned advantages relating to the simplicity of execution and cost saving.
