Early Loading of Four or Five Astra Tech Fixtures with a Fixed Cross-Arch Restoration in the Mandible

Abstract

Early Loading of Four or Five Astra Tech Fixtures with a Fixed Cross-Arch Restoration in the Mandible B. Collaert, H. De Bruyn, Clin Implant Dent Rel Res, 2002;4:133–135 Reduction of the extended postoperative period before placement of a final implant-supported restoration is likely to be perceived as beneficial by most patients. With this in mind, several recently developed clinical protocols have focused on the reduction of the postoperative healing phase before definitive restoration. Many of these involved placement of a fixed, implant-supported mandibular restoration in edentulous patients on the day of implant installation. The advantage of this approach is the immediate functional restoration of edentulous patients. One potential shortcoming of the procedure is the possible detrimental effects on osseointegration. Additionally, consideration must be given to the need to extend the surgical procedure with a time intensive construction and placement of the immediate prosthodontic restoration. The present study reports on 25 patients who received four or five implants in edentulous mandibles (total of 114 implants). Impressions were made immediately following surgical implant installation. Definitive, fixed, metal-resin, mandibular restorations were placed within 1 month after implant surgery. Radiographs made at the time of prosthesis placement were compared with radiographs made at the completion of the study 7 to 24 months later. No postoperative complications were noted, and no implants were lost during the follow-up period. The mean bone loss was recorded to be 0.7 mm. Final bone levels were indirectly related to abutment heights—short abutments being associated with greater bone loss. These authors demonstrated an effective clinical protocol for expediting placement of a definitive mandibular fixed restoration in edentulous patients. This 1-month protocol provided ample time for construction of a metal-resin prosthesis and yet restored the patient sooner than would be accomplished using more conventional approaches. Based on indicators monitored in this study, long-term successful performance of these restorations is expected.