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Implantology — Immediate Loading

Is this implant a reasonable candidate for immediate loading, and what threshold is this decision generally weighed against?

Case

An implant placed in the anterior mandible achieves an insertion torque of 45 Ncm with high primary stability.

No — immediate loading is never appropriate regardless of torque
Correct —Yes — the minimum insertion torque generally cited for immediate loading is around 35 Ncm (some protocols use ISQ instead)
Yes — any torque above 15 Ncm is sufficient for immediate loading
Immediate loading depends only on bone density; torque is irrelevant

Explanation

The minimum insertion torque generally cited as a threshold for immediate loading is around 35 Ncm, though many clinicians also confirm with ISQ (resonance frequency analysis), since torque and ISQ don't always correlate perfectly across bone types. At 45 Ncm in dense anterior mandibular bone, this case has good primary stability and is a reasonable immediate-loading candidate — final judgment still factors in the occlusal loading scheme.

Clinical Pearl

Torque alone isn't the full picture. Checking ISQ alongside torque catches cases where a high torque reading doesn't match actual bone-implant stability.

Reference: Immediate loading protocol, implant primary stability literature

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