Immediate functional loading of immediate implants in edentulous arches: two-year results.

The purpose of this study was to evaluate the clinical success of immediate functional loading of immediate implants in edentulous arches. Five maxillary and five mandibular jaws were treated, and a total of 91 implants were placed; 66 of these implants were placed immediately after tooth extraction, and 25 were placed in healed sites. No bone substitutes or barrier membranes were used. Within 24 hours, fixed temporary restorations were inserted in all cases. During the entire 6-month healing time, all fixed temporary restorations were in normal function, after which the final fixed implant-supported restorations were inserted. After 24 months, the overall success rate of the implants was 92.31% (87.50% for the maxillary implants and 97.26% for the mandibular implants). The bone level measured mesially and distally was in 93.40% of all cases between the implant shoulder and the first thread. The present study shows that the immediate functional loading of immediate implants without the use of any bone substitutes or barrier membranes for fixed complete-arch reconstructions can be successful over a 2-year period.     

Immediate loading of dental implants in the edentulous maxilla: case study of a unique protocol

Although immediate loading of dental implants is increasingly gaining recognition as an important option for certain categories of implant patients, the maxillary arch has historically posed difficulties that have limited the number of immediate loading applications. To address the needs of patients who cannot tolerate maxillary removable complete dentures, an immediate loading protocol we call "Teeth in a Day" uses a conversion prosthesis that has been expanded to include complete-arch maxillary reconstruction. Use of a large number of implants to prevent micromotion at the bone-to-implant interface is a critical element in this protocol. A patient treatment is reported.     

Restoration of partially edentulous patients using dental implants with a microtextured surface: a prospective comparison of delayed and immediate full occlusal loading

PURPOSE: The aim of this study was to determine the clinical effectiveness of placing dental implants with microtextured surfaces into full occlusal loading at the time of placement in partially edentulous patients. MATERIALS AND METHODS: Two demographically similar groups of 14 patients each were treated with a total of 92 Spline Twist Implants (Centerpulse Dental, Carlsbad, CA). Test implants were placed into immediate full occlusal loading, and control implants were restored using a conventional delayed loading procedure. Otherwise, both groups of patients received similar therapy from the same treatment team. Radiographs, periodontal indices, and Periotest values were recorded every 6 months during routine clinical follow-up appointments. The mean loading time for all prostheses was 24 months at the time of this report. RESULTS: No implants failed in the test group, and 1 implant failed before loading in the control group. Cumulative implant success was 98.9% for all implants placed (test group = 100%; control group = 92.9%). Periodontal measurements indicated no significant clinical differences between implants placed into immediate full occlusal loading and those loaded via a conventional delayed protocol. DISCUSSION: Immediate full occlusal loading of partial prostheses supported by microtextured implants in partially edentulous patients demonstrated excellent clinical results, with no adverse periodontal effects after 24 months of function. Additional follow-up will provide invaluable information on the long-term effects of this technique. CONCLUSION: Immediate full occlusal loading of partial prostheses supported by microtextured implants can be successfully achieved for 24 months in highly motivated patients with excellent oral hygiene.     

种植牙即刻负重的生物力学的三维有限元分析

目的 用三维有限元的方法分析牙种植体不同角度即刻负重的骨界面应力分布规律.方法 选成人无牙下颌骨进行薄层螺旋CT扫描,将扫描图像导入通用外科手术集成系统,建立下颌骨三维网格模型.模拟标准的螺纹实心种植体,建立种植体一下颌骨即刻负重的三维有限元模型.以150 N的力轴向加载和分别10.、20.、30.侧向加载,应用ANS...     

Five-year prospective study of immediate/early loading of fixed prostheses in completely edentulous jaws with a bone quality-based implant system

Background: The concept of immediate loading of root‐form implants for fixed restorations has received increasing interest over the last 5 years. Several authors have commented on parameters that may influence results, including implant number, implant length, bone density, and patient habits. The trigger for bone remodeling around an implant may occur from the surgical trauma of insertion or the mechanical environment of strain at the interface. In the classic two‐stage approach, these were divided episodes, separated by 3 to 6 months. Immediate loading compresses this time frame; the two driving mechanisms for bone repair occur concurrently. A scientific approach to the interface development is to match the bone healing response of trauma (woven bone of repair) to the response of mechanical load (reactive woven bone), so the sum of these two entities does not result in fibrous tissue formation and clinical mobility of the implant. Purpose: It is the purpose of this article to review the scientific rationale of these statements and coordinate them to bone physiology and bone biomechanics. Materials and Methods: Findings from previous reports in the literature were reviewed and summarized to form the basis of a prospective study using a bone quality‐based implant system (Biohorizons, Maestro Dental Implants, Birmingham, AL, USA). A transitional prosthesis was delivered either on the day of surgery or within 2 weeks for 30 patients and 31 arches. A total of 244 implants were used to support these restorations, for an average of 7.8 implants per prosthesis. After 4 to 7 months, the final restorations were fabricated. One year after the final restoration was loaded, the implant survival was 100%; the 31 restorations also had a survival of 100% over this time frame. This report presents these implants and restorations over a 1‐ to 5‐year period, with an average follow‐up period of 2.6 years. Results: The bone loss from implant insertion to final prosthesis delivery averaged 0.7 mm. The first‐year bone loss after final prosthesis delivery averaged 0.07 mm. A slight increase in bone height was observed after the first year, but generally no increase was observed over the remaining evaluation period. Conclusions: In the current report, no implant failure occurred, and crestal bone loss values were similar to or less than values reported with the conditional two‐stage approach. This may be related to the number and position of implants, implant design, and/or the surface condition of the implant loading.     

Clinical performance of provisional screw‐retained metal‐free acrylic restorations in an immediate loading implant protocol: a 242 consecutive patients' report

Objective: To evaluate the clinical performance of provisional screw‐retained metal‐free acrylic restorations in an immediate loading implant protocol. Material and methods: Two hundred and forty‐two consecutive patients were selected retrospectively, who received 1011 implants and 311 immediate provisional screw‐retained implant restorations (2–4 h after implant surgery). The patients were monitored for a period of 2–3 months, until they were referred for a final restoration. The primary variables recorded include the survival time and the appearance of fractures in the provisional restoration, and the independent variables included age, sex, dental arch, type of restoration, type of attachment and components used, as well as cantilevers and opposing dentition. A survival analysis (Kaplan–Meier) and a Cox regression analysis were performed. Results: Twenty‐three restorations in 20 patients (8.26%, 95% CI 4.8–11.7) showed at least one fracture (7.39%). More than half of the new fractures (52%, 12 cases) occurred in the first 4 weeks. The cumulative survival probability observed was greater in mandible (P=0.05) and non‐cantilever restorations (P=0.001), and in those opposed by full restorations or natural teeth (P=0.001). With an opposing implant‐supported prosthesis, the risk of fracture was multiplied by 4.7, and the use of cantilevers as well as the location of the restoration in the maxilla multiply the risk by 3.4–3.5. Conclusions: Immediate provisional screw‐retained metal‐free implant‐supported restorations can be considered a reliable restoration (92.6% remain intact) for the healing period of 3 months. To cite this article:
Suarez‐Feito JM, Sicilia A, Angulo J, Banerji S, Cuesta I, Millar B. Clinical performance of provisional screw‐retained metal‐free acrylic restorations in an immediate loading implant protocol: a 242 consecutive patients' report.
Clin. Oral Impl. Res. 21 , 2010; 1360–1369.
doi: 10.1111/j.1600‐0501.2010.01956.x     

Comparative analysis of immediate functional loading and immediate nonfunctional loading to traditional healing periods: a 5-year follow-up of 550 dental implants

Background: Clinical, radiographical, and histological findings have shown that immediately loaded implants show the presence of mineralized tissues at the interface.
Purpose: The aim of this study was to compare an immediate loading protocol with a two-staged one using an implant with a square thread design.
Materials and Methods: One hundred fifty-five consecutive patients (71 men, 84 women), aged between 18 and 78 years (mean: 54 years) participated in this study. A total of 550 implants (Maestro; BioHorizons, Birmingham, AL, USA) were inserted. In group A, 264 implants were inserted in 82 patients with immediate functional loading with occlusal contact if the patients were completely edentulous, or with immediate nonfunctional loading without occlusal contact if the patients were partially edentulous. In group B, 286 implants were inserted in 73 patients with a one-stage or two-stage surgical procedure. All patients were followed for at least 5 years.
Results: In the immediately loaded implants group, three implants failed, all in posterior mandibular sites, with an overall 98.8% 5-year survival rate. In the control group, no implant failed, with a 100% 5-year survival rate. No statistically significant differences were found in the survival rates of the implants in the two groups.
Discussion: A very high implant survival rate was also present in our series for the immediately loaded implants. All the three failed implants were retrieved from the same patient, who had poor oral hygiene, after a loading period of 5 years. These data can suggest that, from a clinical point of view, an abbreviated healing period is compatible with the development and maintenance over a longer time period (5 years) of mineralized tissues at the interface with dental implants.
Conclusion: We can then conclude that shorter healing periods can be highly satisfactory from a clinical point of view.     

Early loading of implants with fixed dental prostheses in edentulous mandibles: 4.5‐year clinical results from a prospective study

Aim: The purpose of this study was to evaluate the survival and success of early‐loaded implants placed in the intraforaminal area of the edentulous mandible, and the survival of the implant‐supported fixed dental prostheses (FDP). Material and methods: Thirty‐seven patients (18.9% male, mean age 64.5 years) with edentulous lower jaws were treated with implant‐supported FDPs in the mandible. One hundred and eighty‐five screw‐type implants were placed in the intraforaminal area of the symphysis (five implants per patient). Immediately after implant placement, a framework was fabricated and the FDP was manufactured on the framework. Within 2 weeks, the implants were rigidly connected and loaded with the implant‐retained FDP. Results: During the 1–8‐year observation period (mean 4.5 years), a total of 32 implant‐retained complications occurred. Nineteen implants were lost in 10 patients, resulting in a cumulative survival of 89.7%. Nine implants in five patients did not osseointegrate. Although these implants were not removed, because stability within the connective tissue was acceptable and inflammation was absent, they were recorded as unsuccessful. Consequently, the cumulative success declined to 84.9%. Four implants in three patients had clinical signs of periimplantitis (2.2% of all implants). Denture‐related complications included one complete failure, when one FDP had to be removed after the last of five implants had been replaced. Furthermore, 10 fractures of the framework occurred in six patients, three FDPs had to be adapted or modified, and the facing of the FDP had to be repaired 16 times in 11 patients. Conclusion: Although one‐stage early‐loaded implants functioned well for most patients with edentulous mandibles, immediate loading is associated with a larger number of implant‐related complications than in other studies investigating delayed loading. Because of the substantial prosthetic complications and aftercare, this procedure cannot be generally recommended. To cite this article:
Schwarz S, Gabbert O, Hassel A J, Schmitter M, Séché C, Rammelsberg P. Early loading of implants with fixed dental prostheses in edentulous mandibles: 4.5‐year clinical results from a prospective study.
Clin. Oral Impl. Res. 21 , 2010; 284–289.
doi: 10.1111/j.1600‐0501.2009.01843.x     

Parallel screw cylinder implants: comparative analysis between immediate loading and two-stage healing of 1,005 dental implants with a 2-year follow up

Background Recently, several authors have focused on the possibility of an immediate functional loading of dental implants to minimize the delay between surgical and prosthetic phases. Purpose The aim of this study was a reevaluation of the XiVE® dental implant (Dentsply‐Friadent, Mannheim, Germany) with: (1) a longer follow‐up period; (2) a higher number of fixture; and (3) a proper statistical method. Materials and Methods In July 2001 and December 2002, 371 patients (180 males and 191 females; ages ranging from 17 to 83; mean age, 53 years) were consecutively enrolled in this study. In 371 patients, a total of 1005 XiVE dental implants were distributed as follows: 484 immediately loaded implants (test group) were inserted in 130 patients, whereas 521 unloaded implants were inserted in 241 patients (control group). Results The implant survival was 98.7 and 99.4% in immediate loading and control group, respectively. Univariate analysis showed no statistically significant difference between the two groups. Conclusion In a previous report, we showed that immediate loading offered a predictable and reliable procedure also for XiVE implants, at least in the short period. In this study, we confirmed the results of the previous study and added information regarding the survival rate and marginal bone level stability with a 2‐year follow up.     

Rehabilitation of the edentulous maxilla and mandible with fixed implant-supported restorations applying immediate functional loading: a treatment concept

The rehabilitation of the complete edentulous arch with fixed implant-supported bridges can be a particular challenge for the practitioner. In the treatment concept presented, each jaw is provided with sufficient implants to realize fixed restorations under immediate (2-3 days after surgery) functional loading. After a healing time of 40 to 60 days, the metal/resin transitionals are exchanged for definitive metal/porcelain bridgework under gnathological aspects. Fixed implant-supported bridges correspond to the arches of natural teeth and can reveal better results in function, phonation, and aesthetics than removable prostheses.     

Extractions, implant placement, and immediate loading of mandibular implants: a case report of a functional fixed prosthesis in 5 hours

The purpose of this report is to present a reliable surgical and prosthodontic protocol for immediate loading of implants, allowing patients to receive a fixed implant-supported prosthesis in a matter of hours. The surgical, prosthodontic, and laboratory steps for this protocol of immediate functionally loading the implants are described for the treatment of a 51-year-old woman who presented with a hopeless mandibular dentition and an edentulous maxillary arch. It is possible to decrease the treatment time in successfully restoring the patient's oral function by means of immediate functional loading of dental implants and immediately placing a fixed implant-supported prosthesis. Compared with the traditional implant protocols, this protocol of a one-visit approach for patient treatment 1) decreases the number of office visits; 2) decreases the treatment time; 3) reduces the patients' costs; 4) allows the patient to avoid wearing a removable interim prosthesis; and 5) increases the patients' acceptance of treatment while maintaining predictability in treating mandibular edentulism.     

Immediate loading of dental implants in the edentulous mandible: a preliminary case report from an international prospective multicenter study

The ability to predictably achieve long-term osseointegration in patients with compromised anatomical resources has been demonstrated numerous times in modern oral implantology. Recently, clinical attention has focused on new methods of reducing treatment time. One-stage surgical procedures and immediate loading of implants at the time of placement are two techniques that have demonstrated promising clinical results. A prospective clinical study of immediately splinting and loading a new, one-stage implant is currently in progress in the United States and France. An overview of the implant design and presentation of one case study from the University of Pittsburgh demonstrates how this promising technique is performed.