Clinical Evaluation of Immediate Loaded Upper Anterior Single Implants

Abstract

Among the guidelines to be followed in the selection of patients who are suitable for treatment with dental implants, there must be accurate assessment and evaluation of the factors that will lead to a functionally long-lasting and aesthetically pleasing result. The latter, which includes the maintenance and development of hard and soft tissues, undoubtedly presents a significant challenge in clinical implantology. The purpose of this study was the clinical evaluation of the methods currently available for the aesthetic restoration of the anterior maxilla using single implants that were loaded immediately. Forty-three patients were treated over 2 years using single implants with immediate nonfunctional loading. The patients were divided into two groups, groups A and B (i.e., immediate implant installation and late implant installation, respectively). Guided bone regeneration techniques were performed in 10 patients in group A and three patients in group B and involved buccal fenestrations orbuccal dehiscence around the implants. The parameters studied were: 1) the anatomical requirements necessary in selecting such patients and the limitations that might affect (to a lesser or greater degree) the desired results; 2) the planning and application of surgical techniques, both with immediate and short-term delay postextraction implantation, as well as the placing of implants in areas with long-term dental loss; and c) the results, after radiologic and clinical follow-up visits every 6 months, for an overall period of 2 years. No implant failure was recorded, and the therapeutic procedures were considered completely successful in all cases, without significant radiographic peri-implant marginal bone loss (i.e., average bone loss in mm +/- SD, 0.75 +/- 1.05 in group A and 0.875 +/- 0.625 in group B) or significant clinical differences in peri-implant sulcus depth (average difference in mm +/- SD, 0.3 +/- 0.2 in group A and 0.4 +/- 0.375 in group B). In cases where guided bone regeneration techniques were applied, the results were considered successful and final, and the aesthetic results were deemed more satisfactory than was expected. The procedure was successful in all cases in terms of both osseointegration and aesthetics. The use of dental implants with nonfunctional loading in particularly sensitive aesthetic areas is recommended unreservedly, given the existence of the anatomical requirements, good initial stability, and the absence of extensive bone loss in the area receiving the implant. In addition, application of this treatment method leads, within a very short time, to a particularly successful aesthetic result, reducing the number of surgeries and the duration of treatment.