Immediate versus early loading protocols of titanium—zirconium narrow‐diameter implants for mandibular overdentures in edentulous patients: 1‐year results from a randomized controlled trial

Abstract

The purpose of this randomized clinical trial was to compare immediate and early loading protocols for mandibular overdentures with two-splinted narrow-diameter implants in thin, non-augmented residual ridge situations. Each edentulous patient received two implants in the interforaminal region. If primary stability after implant placement was achieved, patients were randomized either to the immediate (48hr post-surgery) or the early (2weeks after surgery) loading group. In prosthetic rehabilitation, a bar prosthetic system with a titanium bar was used. Implant survival, success rates, and radiographic changes at the crestal bone level were evaluated after 1year, and patient satisfaction was recorded at 1 and 6months post-surgery. Twenty-four patients with a mean age of 67±9years were included. One patient passed away after 11months due to treatment-independent reasons. In the 24 implants of the immediate loading group, the mean bone level change from surgery/loading to the first-year evaluation was 0.32±0.80mm (p=.066). Regarding the early group (22 implants), the mean bone level change from loading to 1year was 0.34±0.69mm (p=.048). After 1year, no differences could be detected between groups (p=.91) with a mean difference of 0.02mm (95% CI: [-0.42, 0.47]). The mean implant survival and success rates were 100% for both groups. Patient satisfaction was high; however, at 6months, there was a difference between groups regarding the ability to chew. Both loading protocols for mandibular overdentures supported by two-splinted narrow-diameter implants were successful at the 1-year follow-up.