Fixed teeth in 24 hours vs immediate-load dental implants

If you are facing the loss of one or more teeth and have started looking for solutions, you have no doubt come across medical terms such as ‘fixed teeth in 24 hours’ and ‘immediate-load implants’.  

In this article, Dr Cătălin Mărtișcă, a specialist in dento-alveolar surgery, explains in detail each of these two solutions for replacing missing teeth, what each procedure involves and what the costs are.  

Understanding these differences is extremely important for choosing the right solution, whilst following the advice of a specialist in dento-alveolar surgery. 

The phrase ‘Fixed teeth in 24 hours’ describes a treatment protocol designed for patients with complete edentulism in one or both dental arches.

The procedure involves placing 4 or 6 dental implants, strategically positioned in a single arch (upper or lower), to which a either during the same procedure or within 24–48 hours, a temporary fixed prosthesis is attached. The patient leaves the clinic with fixed, functional and aesthetically pleasing teeth.  

“The key technical aspect is the angulation of the posterior implants (30–45 degrees), which allows for anchoring in denser bone areas and, in most cases, avoids the need for bone grafts,” explains Dr Cătălin Mărtișcă.

Important: The permanent fixed restoration is fitted after 3–6 months, once osseointegration of the implants is complete. 

Stages of treatment:

• Consultation and planning: assessment based on radiological investigations (X-rays and computed tomography – CBCT), digital scanning, and drawing up the treatment plan.  
• Surgical procedure: extraction of non-restorable teeth (if necessary) and placement of 4–6 implants per arch.  
• Fitting of the temporary prosthetic restoration: carried out during the same appointment or within a maximum of 24–48 hours.
• Healing period: 3–6 months of osseointegration, with a suitable diet (soft foods).
• Fitting of the final prosthetic restoration: once complete osseointegration of the implants has been confirmed.

Benefits of the ‘Fixed Teeth in 24 Hours’ procedure:

• A permanent and long-lasting solution, achieved through a single major procedure;
• Eliminates the discomfort and social stigma of complete edentulism;
• In most cases, avoids the need for costly bone grafts;
• You leave the clinic with fixed teeth on the very day of the operation;
• Immediate improvement in your quality of life: you can eat, speak and smile normally. 

An immediate-load dental implant is a procedure generally used to replace one or more isolated teeth. Unlike a conventional dental implant, which requires waiting for the osseointegration period to be complete – a process that can take between 3 and 6 months – immediate loading allows a temporary crown to be fitted on the day of the procedure or within the first 48 hours.

The immediate-loading dental implant procedure

In traditional implantology, the standard protocol involves the following stages:

• Placement of the screw in the bone;
• A healing period of 3–6 months without a restoration attached (osseointegration in the absence of mechanical stress);
• Exposure of the implant via a second surgical procedure;  
• Fitting of the prosthetic abutment and the final crown.

“In the case of immediate loading, the temporary crown is fixed to the dental implant immediately after the screw is placed, eliminating the waiting period during which no tooth is visible,” explains Dr Cătălin Mărtișcă.

The key difference from ‘Fixed Teeth in 24 Hours’ is that immediate loading refers to a single implant (or multiple single implants), not to the restoration of an entire arch. These are two completely different procedures in terms of scope and clinical indication.

Stages of treatment

Pre-operative assessment: analysis of bone quantity and quality, based on X-rays and CT scans;  

Surgical procedure: tooth extraction (if present) and placement of the implant;

Assessment of primary stability: the dentist checks that the minimum safety torque (at least 35 Ncm) has been achieved to allow for immediate loading;

• Fitting of the temporary crown: during the same appointment;  
• Healing period: 3–6 months of osseointegration;
• Permanent crown: fitted once complete integration of the implant has been confirmed.

To gain a clearer understanding of the practical differences between the two solutions for replacing missing teeth – including in comparison with the traditional delayed-loading implant – please refer to the comparison table below: 

*Prices are indicative and may vary depending on the complexity of the case, the number of implants, the materials used and the clinic chosen.

There is no one-size-fits-all solution. The decision between fixed teeth in 24 hours and an immediate-load implant depends on several factors, which the specialist will assess following a thorough examination.

Bone quantity and quality

This is the most important medical criterion. Dense bone of sufficient volume allows for good primary stability and makes immediate loading possible. Atrophied or porous bone, typical of long-term tooth loss or certain systemic conditions, may require bone grafts or may preclude immediate loading.

“The assessment of bone quality and quantity must be carried out using 3D computed tomography, not just conventional panoramic X-rays. Only in this way can we determine which of the three solutions for replacing missing teeth is the most suitable.” – Dr Cătălin Mărtișcă

Number of missing teeth

This is the main distinction between the two procedures:

• 1–3 isolated missing teeth: a single implant with immediate loading is the appropriate solution;
• Multiple or complete edentulism: the All-on-4/All-on-6 protocol (fixed teeth in 24 hours) is recommended;
• Mixed cases: the dentist will draw up a combined treatment plan, tailored to your specific case.

Available budget

The cost of the two procedures differs significantly. The immediate-load implant has a lower cost per unit (900–1,200 EUR), but if you need several teeth, the total cost adds up.  

The ‘Fixed Teeth in 24 Hours’ protocol using the All-on-4/All-on-6 system (€4,300–5,700 per arch) may seem more expensive initially, but it offers a complete solution for the entire arch in a single procedure.

At DENT ESTET, every patient’s treatment plan includes a transparent breakdown of costs before any decision is made.

Time required

If your priority is to have fixed teeth as quickly as possible and to minimise the number of visits to the clinic, both procedures offer this option, provided there is clinical eligibility for immediate loading.

If your clinical situation does not allow for immediate loading, the dentist will recommend the standard protocol (delayed loading), which, although taking longer, offers predictable and long-lasting results.

Common benefits: rapid restoration, functionality and aesthetics

Both the ‘Fixed Teeth in 24 Hours’ treatment and the immediate-loading implant share significant advantages over conventional prosthetic solutions:

• Rapid restoration: both offer an immediate aesthetic and functional solution, without months of waiting;
• Full functionality: you can eat, speak and smile naturally from the day of the procedure (with the temporary restoration);
• Superior aesthetics: the temporary restoration looks natural and maintains the harmony of your smile;
• Psychological comfort: it eliminates the discomfort and anxiety associated with tooth loss;
• A single major surgical procedure: unlike the traditional two-stage protocol;
• High success rates: 92–98 per cent long-term survival rate in appropriately selected cases.

Key differences and situations where a particular treatment is recommended

‘Teeth in 24 Hours’ is recommended when:

• You have lost all or most of your teeth in one jaw;
• You are dissatisfied with your removable dentures and want a permanent, fixed solution;
• You are experiencing bone atrophy, but there are sufficient areas of dense bone for implant anchorage;
• You wish to minimise the number of surgical procedures and clinic visits.

Immediate loading implants are recommended when:

• You have 1–3 isolated missing teeth;
• The quality and quantity of bone in the treatment area are good;
• The primary stability of the implant meets the required threshold (minimum 35 Ncm);
• You have no systemic conditions that could compromise healing;
• You are not an active smoker and do not suffer from severe bruxism.

A conventional implant is recommended when:

• Bone quality is poor or a bone graft is required;
• Primary stability is insufficient at the time of placement;
• There are uncontrolled systemic conditions (uncontrolled diabetes, immunosuppression);
• There have been recent extractions with bone currently undergoing remodelling. 

• Long-term clinical outcomes of immediate loading versus non-immediate loading in single-implant restorations by Mansour Rismanchian, Reza Khodadadi, Tohid Khodadadi, Tina Khodadadi, Hamed Rismanchian, Alireza Rahimi