Clinical efficacy of early loading versus conventional loading of dental implants.

Yanfei Zhu,Yi Xu,Eryi Lu,Xinhua Qu,Min Zhu,Guanqi Zeng,Xinyi Zheng

doi:10.1038/srep15995

Yanfei Zhu, Yi Xu + Show 5 more

Open Access

https://doi.org/10.1038/srep15995

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Abstract

The aim of this study was to determine the clinical differences between early and conventional loading protocols for dental implants. A comprehensive search of the Medline, Embase, and OVID databases for studies published through January 10, 2015 was conducted. Fourteen studies were included in our analysis. We found that early loading imposed a significantly higher risk of implant failure than did conventional loading (risk ratio = 2.09, 95% confidence interval [CI] [1.18, 3.69], P = 0.01), while no significant differences between the methods were found with regards to the marginal bone loss (weighted mean differences [WMD] = 0.11, 95% CI [−0.07, 0.28], P = 0.23), periotest value (WMD = 0.02, 95% CI [−0.83, 0.87], P = 0.96), or implant stability quotient (WMD = 0.79, 95% CI [−0.03, 1.62], P = 0.06). As for the health status of the peri-implant tissue, conventionally loaded implants demonstrated better performance than did early loaded implants. Subgroup analyses demonstrated that the sample size, time of publication, loading definition, implant position, extent, and restoration type influenced the results. Although early implant loading is convenient and comfortable for patients, this method still cannot achieve the same clinical outcomes as the conventional loading method.

Highlights

Since Branemark introduced the osseointegration system in 19771, a healing period of at least 3–4 months without loading has been advocated to achieve osseointegration of dental implants[2]
A recent meta-analysis corroborated the findings of previous studies showing that immediate loading is associated with a significantly higher implant failure rate, lower marginal bone loss, and a higher implant stability quotient (ISQ) compared to conventional loading[9]
The results showed that early loading imposed a significantly higher risk of implant failure compared to conventional loading (RR = 2 .09, 95% CI [1.18, 3.69], P = 0 .01)

Summary

Introduction

Since Branemark introduced the osseointegration system in 19771, a healing period of at least 3–4 months without loading has been advocated to achieve osseointegration of dental implants[2]. When the micromotion reaches a certain threshold, it can eventually lead to failure of the implant[5] This nonloading period is usually troublesome and is associated with functional and aesthetic disturbances, especially in completely edentulous patients due to the need to use removable dentures[6,7]. A recent meta-analysis corroborated the findings of previous studies showing that immediate loading is associated with a significantly higher implant failure rate, lower marginal bone loss, and a higher implant stability quotient (ISQ) compared to conventional loading[9]. The aim of this study was to determine whether or not early loading resulted in different clinical outcomes than conventional loading in terms of the implant failure rate, marginal bone loss, implant stability, peri-implant parameters, and complications

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