Success Rates of Immediately Loaded Implants in the Maxilla – A 10-year Follow-up Study

Abstract

Abstract Introduction: To restore missing teeth in the mouth, dental implants are crucial. Total edentulism leaves the patient unable to chew, smile or communicate well, which can cause a psychological collapse in day-to-day activities. The objectives of this retrospective study were to report the 10-year success rates of patients with immediately loaded implants in the fully edentulous maxilla by measuring the bone level at the coronal/crestal aspect annually and also to determine the survival rates and complications of the full-arch prosthesis. Materials and Methods: Seventy-seven implants (Ankylos, Dentsply, Tulsa, OK, USA) were inserted and immediately loaded in 10 fully edentulous maxillae. Patients were rehabilitated with a cement-retained metal-reinforced provisional bridge of 10–12 units, and all implants were loaded on the same day of placement. At the 12-month follow-up and each year thereafter, the prostheses were removed, and a clinical evaluation of the peri-implant tissues and implant mobility was made for each implant. The age of the patients included in the study ranged between 45 and 77 years, with the average age being 61 years old. Radiographic bone levels were recorded post-loading at years 1–10 annually. Results: In the group of immediate loading with simultaneous augmentation, 19 of 47 implants had received vertical or horizontal augmentation due to insufficient ridge height or width. In the other group, none of the 30 immediately loaded implants received augmentation either before or simultaneous with implant placement. After a clinical and radiographic follow-up period of 12–130 months, none of these implants were lost, and the probing depths around the implants were within normal limits. None of the prostheses reported prostheses loosening, abutment screw loosening or abutment screw fracture. In one case, maxillary fixed full-arch cement-retained final prostheses had to be replaced due to a fracture of the prostheses framework, and in two cases had to be replaced due to extensive ceramic chipping; hence, the cumulative survival rate of the prostheses was 70% at the end of 10 years. Conclusion: These results seem to demonstrate that a maxillary fixed full-arch prosthesis that is supported by at least six to eight implants in uniform distribution, even with simultaneous grafting, allows good long-term success for immediately loaded implants.