Abstract
The purpose of this study was to compare the implant survival, peri-implant marginal bone level, and peri-implant soft tissue of three different types of implants. This was performed with an early loading protocol, using a complete digital workflow, for one year of follow-up. Twenty-four patients with a single missing tooth in the mandibular posterior region were randomly assigned to the control group (SLActive Bone level implant; Institut Straumann AG, Basel, Switzerland), experiment group 1 (CMI IS-III Active implant; Neobiotech Co., Seoul, Korea), and experiment group 2 (CMI IS-III HActive implant; Neobiotech Co., Seoul, Korea). For each patient, a single implant was installed using the surgical template, and all prostheses were fabricated using a computer-aided design/computer-aided manufacturing system on a 3-dimensional model. A provisional prosthesis was implanted at 4 weeks, and a definitive monolithic zirconia prosthesis was substituted 12 weeks following the implant placement. The implant stability quotient (ISQ) and peri-implant soft tissue parameters were measured, and periapical radiographs were taken at 1, 3, 4, 8, 12, 24, 36, and 48 weeks after implant placements. Seven implants in the control group, nine implants in the experiment 1 group, and eight implants in the experiment 2 group were analyzed. There were no significant differences among the three groups in terms of insertion torque, ISQ values between surgery and 8 weeks of follow-up, marginal bone loss at 48 weeks of follow-up, and peri-implant soft tissue parameters (P > 0.05). Statistically significant differences in ISQ values were observed between the control and experiment 1 groups, and the control and experiment 2 groups at the 12 to 48 weeks’ follow-ups. Within the limits of this prospective study, an early loading protocol can be applied as a predictable treatment modality in posterior mandibular single missing restorations, achieving proper primary stability.
Highlights
According to Branemark’s original protocol, in order to obtain a direct bone-to-implant interface, dental implants need to be submerged under the soft tissue and left for 3–6 months [1]
A provisional restoration was installed according to the early loading protocol, and the final prosthesis was mounted 12 weeks (3 months) after implant placement
Two subjects were excluded during the surgery because they were not suitable for conducting the clinical trial due to mouth limitations or patient discomfort caused by proximity to the nerve
Summary
According to Branemark’s original protocol, in order to obtain a direct bone-to-implant interface (osseointegration), dental implants need to be submerged under the soft tissue and left for 3–6 months [1].The rationale of the unloading period is to avoid movements of the dental implant during the healingMaterials 2020, 13, 3912; doi:10.3390/ma13183912 www.mdpi.com/journal/materialsMaterials 2020, 13, 3912 process of the bone that may interfere with osseointegration between the bone and implant, resulting in fibrous encapsulation [2].Many efforts have been made to shorten the restoration period, in order to reduce patient discomfort. According to Branemark’s original protocol, in order to obtain a direct bone-to-implant interface (osseointegration), dental implants need to be submerged under the soft tissue and left for 3–6 months [1]. Several studies have shown that submerging the dental implants under the soft tissue is not necessary for successful implant restoration [3,4,5,6]. Implant surfaces have been improved to reduce treatment time including an early loading protocol following implant placement [7]. From this evidence, implant placement can be performed following an early loading protocol with non-submerging, in order to reduce the restoration periods
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