Abstract
BackgroundThis study evaluated full-arch rehabilitation of patients with immediately placed implants in terms of the cumulative implant survival rate, risk factors for implant failure, and patient satisfaction.MethodsTime-to-event data of 52 completely edentulous jaws (370 implants) were collected using retrospective clinical chart review for the time period from 2008 to 2014. A conventional two stage approach for surgery was adopted to immediately placed implants in the maxilla, and immediate placement and immediate loading protocols for the mandible were followed. The study calculated the 7-year cumulative survival rates (CSR), and a Bayesian hierarchical Cox proportional hazard model was used to measure the effect of covariates. Patient satisfaction on chewing ability, esthetic appearance, and overall satisfaction was also measured with a face-to-face interview survey.ResultsOf the total 370 implants, 194 were immediate placement. Two delayed loading maxillary implants failed within the first year, and another one failed in the second year of loading. Two failures were recorded in the first year and one in seven years for the immediate loading mandibular implants. The 1-, 5-, and 7-year CSR of the 370 implants were 0.989 (0.979, 1.000), 0.986 (0.975, 0.998), and 0.978 (0.957, 0.999), respectively. Only the length of the implant affected implant failure (p < 0.05); other patient characteristics, systemic diseases, implant diameter, immediate loading, and immediate placement, did not have an effect on implant failure rates. Patients reported a high degree of satisfaction regardless of their age group or length of the observation period.ConclusionsImmediately placed implant had CSR as high as delayed placed implants, and 7-year CSRs of immediate loading were not significantly different from delayed loading. The procedure also had a high degree of chewing ability, esthetic appearance, and overall satisfaction. The study results suggested that the clinical procedures applied in this study to completely edentulous patients were acceptable rehabilitation procedures.
Highlights
This study evaluated full-arch rehabilitation of patients with immediately placed implants in terms of the cumulative implant survival rate, risk factors for implant failure, and patient satisfaction
The total number of patients included in the study was 26 (52 jaws), the mean observation period was 55 months, and 5 patients were lost to follow-up
At the time of implant placement, approximately 12.7 teeth were extracted per patient, and more than 52% of all 370 (194 implants) were immediately placed implants
Summary
This study evaluated full-arch rehabilitation of patients with immediately placed implants in terms of the cumulative implant survival rate, risk factors for implant failure, and patient satisfaction. Placed and immediately loaded implant rehabilitation has spread in the clinical setting, but situations such as poor primary stability may compel the dentist to follow a more conventional placement and a delayed loading protocol [4]. Immediate placement and immediate loading is associated with high survival rates and has been met with increased patient satisfaction [2, 6]. Several modalities have been reported for immediately placed implants and immediately loaded fixed prostheses and subsequent rehabilitation: 2 to 6 implants in the mandible [7, 8] and 4 to 12 implants in the maxilla [9,10,11,12]. The clinical outcomes may depend on the clinicians’ levels of training, experience, and skill [5] as well as proper patient selection
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