Immediately Loaded Research Articles

The Rehabilitation of Partially Edentulous Maxilla With Unilateral Zygomatic Implants: A Retrospective Study up to 23 Years Follow-Up.

This retrospective study aimed to evaluate the clinical outcomes associated with zygomatic implant (ZI) rehabilitation in partially atrophic edentulous maxillae over a mean follow-up period of more than 10.3 years. All consecutive patients underwent ZI rehabilitation between 1999 and 2020, with a minimum follow-up period of 3 years. The primary outcome was the implant survaival rate. Secondary outcomes included the prosthesis success rate, complications, and Oral Health-Related Quality of Life. Of the 21 patients, treated with 27 ZIs and 48 conventional implants (CIs), 9 (42.9%) were females. The mean follow-up was 10.3 ± 5.7 years (range 3.2-23.4). ZI and CI survival rates were 100% and 97.9%, respectively, with one CI that failed. Eleven patients received 12 CIs placed in the pterygoid and tuberosity region. Most of the implants (81.33%) were immediately loaded, with 17 patients (80.9%) receiving 21 acrylic bridges. Of the total of 26 definitive prosthesis, the success rate was 96.1%. Local inflammation (n = 2) and soft tissue recession (n = 1) were reported as complications, occurring at a mean follow-up of 4.5 and 3.2 years, respectively. The mean score of the OHIP-14 questionnaire was 1.19 ± 1.99. Unilateral ZI rehabilitation was a predictable option for patients with partially atrophic edentulous maxilla who have experienced previous graft or implant failures, or who require immediate loading. Splinting the ZI with CI for restoration appeared to be essential in unilateral ZI treatment. Complications were infrequent and could be managed effectively, with patient-reported outcomes indicating normalization in quality of life.

Evaluation of Internal and External Hexagon Connections in Immediately Loaded Full-Arch Rehabilitations: A Multicenter Randomized Split-Mouth Controlled Trial With a 6-Year Follow-Up.

Full-arch immediate loading rehabilitations are now a widely used rehabilitation method that guarantees predictable medium- and long-term results. Numerous factors can influence its success and stability in the medium and long term. Among these the implant-abutment connection seems to play an important role, however there is still little information on which is the most suitable in this type of treatment. The aim of the present multicenter split-mouth controlled trial is to evaluate whether external hexagonal connections (EHC) and internal hexagonal connections (IHC) can influence success, bone resorption and peri-implant parameters in immediate-load full-arch rehabilitations. Twenty patients were rehabilitated with immediately loaded fixed full-arch rehabilitations. All the implants presented the same macro- and micro-topography but different implant-abutment connection. IHC were used in one randomly selected side of the jaw and EHC was used in the other side. Outcome measures were implant survival rate, peri-implant marginal bone loss (MBL), plaque index (PI), probing depth (PD), and bleeding on probing (BoP) evaluated at 3, 6, 12, 36, and 72-month post-loading. Technical and biological complications were recorded. In 20 patients, 43 EHC and 40 IHC implants were placed. Between 32 and 72 months of follow-up two patients withdrew (died) and no implants were lost. The cumulative survival rate (CSR) was 97.44% for EHC implants and 97.22% for IHC implants. The MBL presented a resorption of 2 mm in the EHC group and 1.9 mm in the IHC group. No statistically significant differences were found between the two groups for any of the parameters at any time. No biological or technical complications were detected between the 36th and 72nd month of follow-up. After 72 months in function, both internal and external hexagon connections provided good clinical outcomes and were not associated with any significant difference in the clinical outcomes.

Using the Nasopalatine Canal for Enhanced Distribution in Severely Atrophic Maxilla With Immediate Loading of Zygomatic Implants: An 8-Year Retrospective Cohort Study.

This study presents retrospective 8-year clinical performance data from a patient cohort treated with immediately loaded maxillary full prostheses supported by zygomatic implants combined with implants placed in the nasopalatine canal, as a treatment for severely resorbed edentulous ridges. A retrospective analysis was conducted on data of maxillary edentulous patients with severe bone atrophy. All of them received zygomatic implants in combination with an implant placed in the nasopalatine foramen and an immediately loaded fixed temporary prosthesis in the first 24 hours. The frequency of major and minor adverse events was presented according to the time of occurrence. Fifteen patients were included in the study, without cases of implant loss or sensitivity in the nasopalatine region were observed up to 8 years. Only 1 major complication was observed, whereas minor complications were more frequent. In conclusion, this 8-year follow-up study demonstrated that the nasopalatine canal can be considered a viable implant site, with no major risks, to improve biomechanics by enabling a polygonal distribution in severely atrophic maxillae treated with zygomatic implants and immediate loading.

IMMEDIATE IMPLANT PLACEMENT AND LOADING IN THE MAXILLARY ESTHETIC ZONE DEMONSTRATE HIGH SURVIVAL RATES, BUT ESTHETIC AND FUNCTIONAL SUCCESS DATA IS STILL NEEDED

IMMEDIATE IMPLANT PLACEMENT AND LOADING IN THE MAXILLARY ESTHETIC ZONE DEMONSTRATE HIGH SURVIVAL RATES, BUT ESTHETIC AND FUNCTIONAL SUCCESS DATA IS STILL NEEDED

A Staged Digital Protocol for the Terminal Dentition for Immediate Loading Using a Provi-guide.

This report describes a step-by-step staged digital protocol for the terminal dentition patient using a Provi-guide. This protocol will improve implant placement accuracy, shorten treatment time, and assure an implant-supported fixed complete denture immediately loaded after extraction of the remaining terminal dentition and complete edentulism. The novelty of the Provi-guide technique described is that it serves 2 objectives: (1) a nonlimiting surgical guide, and (2) a fixed interim prosthesis. Implants placed in the described digital stagged protocol can serve both the interim and the final prosthesis.

Three-dimensional finite element analysis of the biomechanical behaviour of different dental implants under immediate loading during three masticatory cycles

The study aimed to evaluate the impact of varying modulus of elasticity (MOE) values of dental implants on the deformation and von Mises stress distribution in implant systems and peri-implant bone tissues under dynamic cyclic loading. The implant-bone interface was characterised as frictional contact, and the initial stress was induced using the interference fit method to effectively develop a finite element model for an immediately loaded implant-supported denture. Using the Ansys Workbench 2021 R2 software, an analysis was conducted to examine the deformation and von Mises stress experienced by the implant-supported dentures, peri-implant bone tissue, and implants under dynamic loading across three simulated masticatory cycles. These findings were subsequently evaluated through a comparative analysis. The suprastructures showed varying degrees of maximum deformation across zirconia (Zr), titanium (Ti), low-MOE-Ti, and polyetheretherketone (PEEK) implant systems, registering values of 103.1 μm, 125.68 μm, 169.52 μm, and 844.06 μm, respectively. The Zr implant system demonstrated the lowest values for both maximum deformation and von Mises stress (14.96 μm, 86.71 MPa) in cortical bone. As the MOE increased, the maximum deformation in cancellous bone decreased. The PEEK implant system exhibited the highest maximum von Mises stress (59.12 MPa), whereas the Ti implant system exhibited the lowest stress (22.48 MPa). Elevating the MOE resulted in reductions in both maximum deformation and maximum von Mises stress experienced by the implant. Based on this research, adjusting the MOE of the implant emerged as a viable approach to effectively modify the biomechanical characteristics of the implant system. The Zr implant system demonstrated the least maximum von Mises stress and deformation, presenting a more favourable quality for preserving the stability of the implant-bone interface under immediate loading.

Adding mechanobiological cell features to finite element analysis of an immediately loaded dental implant.

Finite element analysis (FEA) has been used to analyze the behavior of dental materials, mainly in implantology. However, FEA is a mechanical analysis and few studies have tried to simulate the biological characteristics of the healing process of loaded implants. This study used the rule of mixtures to simulate the biological healing process of immediate implants in an alveolus socket and bone-implant junction interface through FEA. Three-dimensional geometric models of the structures were obtained, and material properties were derived from the literature. The rule of mixtures was used to simulate the healing periods-immediate and early loading, in which the concentration of each cell type, based on in vivo studies, influenced the final elastic moduli. A 100 N occlusal load was simulated in axial and oblique directions. The models were evaluated for maximum and minimum principal strains, and the bone overload was assessed through Frost's mechanostat. There was a higher strain concentration in the healing regions and cortical bone tissue near the cervical portion. The bone overload was higher in the immediate load condition. The method used in this study may help to simulate the biological healing process and could be useful to relate FEA results to clinical practice.

Immediate Loading of 3-Unit Posterior Fixed Dental Prostheses on 3 Vs 2 Implants, Comparison and Evaluation with up to 10-Year Follow-up.

The aim of this prospective study was to evaluate and compare the implant survival rate, marginal bone levels and prostheses failure rate, of three-unit fixed dental prostheses (FDPs) supported by three vs. two implants immediately loaded in the posterior area. Partially edentulous patients in need of a three-unit implant supported FDP in the maxillary/mandibular posterior region were recruited and randomly split into two groups: Group 1 with three-unit FDP supported by three implants (Control); Group 2 with three-unit FDP supported by two implants (Test). Implants were inserted and immediately loaded with a temporary FDP. Sixty-three patients were included in the study. A total of 178 implants were placed and immediately loaded (128 maxillary/50 mandibular) to support 74 immediate provisional fixed prostheses (52 maxillary and 22 mandibular) delivered on the same day of implant insertion/placement; 30 in Group 1 and 44 in Group 2. The comparison of three vs. two implants resulted in comparable implant survival rate, marginal bone loss, and prostheses failure rate. All implants healed uneventfully with no adverse clinical and radiographical signs or symptoms except for one implant failure in Group 1 resulting in a cumulative success rate of 99,5%, 98,9% for Group 1 and 100% for Group 2 with a follow-up of 6-to-10 (mean 7 years). Once loaded, the implants remained in function from a minimum of 6 years to 10 years. Although more studies and larger sample sizes are needed to validate this study, the results showed no difference between the two Groups, demonstrating the potential viability of both clinical options.

Effect of Acid Surface Treatments on the Shear Bond Strength of Metal Bracket to Zirconia Ceramics

The surface treatment of zirconia prior to bonding remains controversial and unclear. This study aimed to compare the shear bond strength (SBS) of metal brackets to zirconia under surface treatments with either 4% HF or 37% PA in both immediate loading (IML) and artificial aging by thermocycling (TMC). Methods: Eighty-four zirconia were randomly assigned to six groups based on the surface treatment and artificial aging by TMC: (1) No surface treatment (NT); (2) NT + TMC; (3) HF (4% HF for 2 min); (4) HF + TMC; (5) PA (37% PA for 2 min); and (6) PA + TMC. After bracket bonding, only the TMC groups were thermocycled for 5000 cycles. The SBS and adhesive remnant index (ARI) of all groups were analyzed (p < 0.01). Results: TMC significantly lowered the SBS more than the IML in all acid surface treatment groups (p < 0.01). The ARI score after TMC was significantly higher than the IML in all acid surface treatment groups (p < 0.001). No significant differences in the SBS values or ARI scores were observed among the surface treatments (p > 0.01). Conclusions: Two-minute simple etching methods, using either 4% HF or 37% PA, showed an insufficient SBS of metal orthodontic brackets to zirconia after TMC.

Immediate Loading Using the Digitalized Customized Restoration of Single-tooth Implants Placed in Fresh Extraction Sockets in the Aesthetic Anterior Maxilla: A 10-Year Prospective Study of Marginal Bone Level.

The objective of this study was to assess marginal bone level around single implants inserted in fresh extraction sockets in the anterior maxillary region and instantly restored with computer-aided design/computer-aided manufacturing customized temporary crowns cemented on the final abutment. A total of 20 patients (15 females and 5 males, with a mean age of 30 years), where 20 were placed in fresh extraction sockets. After raising a full-thickness flap, atraumatic extraction was performed the implant site was prepared and fixtures were stabilized on the palatal bone wall. The implant location was immediately transmitted to the prepared master model using the pick-up impression coping seated in the surgical guide template. Prefabricated abutments were used as the final abutment on the master model, scanned and the crown was planned using computer-aided manufacturing customized software. Later on 8th weeks, abutments were torqued as per the manufacturer's recommendation, and the final crowns were cemented. Using personalized intraoral radiographs marginal bone level was evaluated mesially and distally to the implant shoulder as a reference at implant placement, 8 weeks, 1, 3, 5, and 10 years after loading. Wholly implants were osteo-integrated positively after 10 years of practical loading, but only 18 were available for clinical and radiological follow-up, and 2 patients with two implants were excluded from the study due to relocation abroad without any implant failure. The average marginal bone loss (MBL) in the current report was 0.16 ± 0.167 mm at crown cementation, 0.275 ± 0.171 mm after 1 year, 0.265 ± 0.171 mm after 3 years, 0.213 ± 0.185 mm after 5 years, and 0.217 ± 0.194 mm at 10 years. The strategy of inserting and not removing the final abutment at the time of implant placement facilitates the establishment of adequate attachment of both soft and hard tissues to the abutment surface, ensuring uninterrupted organization of tissue architecture and offers advantages in helping maintain soft tissue maturation and preventing marginal bone level. Immediately loaded implants in freshly extracted sockets lead to a significant reduction in marginal ridge resorption. The use of a temporary crown on a prefabricated abutment, exclusive of successive abutment manipulation, proved effective in preserving the primarily founding blood clot and served as a prototype for shaping the soft tissue around the previously wounded gum. How to cite this article: Berberi A, El Zoghbi A, Aad G, et al. Immediate Loading Using the Digitalized Customized Restoration of Single-tooth Implants Placed in Fresh Extraction Sockets in the Aesthetic Anterior Maxilla: A 10-Year Prospective Study of Marginal Bone Level. J Contemp Dent Pract 2024;25(3):213-220.

Immediate loading on two adjacent single dental implants with definitive nonsplinted restorations: A proof of concept in the posterior zone.

To evaluate clinical, clinician- and patient-reported outcomes (PROs) of two adjacent single posterior implants immediately loaded with definitive single crowns up to 1 year. Ten patients in need of two adjacent posterior single implants were included. All implants were placed applying a fully digital workflow. Definitive screw-retained single zirconia crowns were delivered within 72 h after implant placement. Clinical parameters, patient- and clinician-reported outcomes were assessed up to 1 year of follow-up. Clinical outcomes remained stable, with no implant failures or technical and biological complications throughout the observation period. Patient satisfaction was very high at baseline (crown delivery) and remained consistently high at 6 and 12 months of follow-up. Crown insertion 3 days after implant placement was rated as an easy procedure by clinicians. Two adjacent single implants with immediate definitive restorations(<72 h) in the posterior region appear to be a viable and easy treatment option to shorten the overall treatment time and potentially enhancing patient satisfaction. However, randomized controlled trials are needed to confirm the advantages of this treatment protocol over a delayed loading approach. In selected cases, immediate implant loading with definitive restorations in the posterior region appears a valuable and straightforward option to shorten the overall treatment time.

A Prospective Study of Immediately Loaded Single Implant-Retained Mandibular Overdentures: Long-Term Results with 15-Year Follow-up.

To investigate the long-term predictability of simplifying mandibular overdenture treatment using single-stage surgery and immediate prosthetic loading of a single implant to provide a more affordable treatment option. A total of 29 patients with a mean age of 68 years with problematic mandibular dentures were treated. A single implant (Brånemark System Mklll TiUnite, Nobel Biocare) was placed into the mandibular midline for primary stability. A ball attachment was placed, and the retentive cap was incorporated into the existing denture. The patients were recalled at 3 and 12 months and at 3, 5, 10, and 15 years. Clinical assessments, radiographs, and resonance frequency analysis were recorded. All complications, failures, maintenance, and reasons for failure to follow-up were noted. Visual analog scale (VAS) questionnaires were used to record patient satisfaction (ANOVA; P < .05). One implant did not achieve sufficient primary stability to be immediately loaded and was treated with a two-stage delayed loading protocol. Of the 28 patients receiving immediately loaded implants, 14 patients were available for follow-up at 15 years. Implant survival remained at 100% throughout the study. Patient satisfaction was high, with a significant increase in all comfort and functional parameters (P values ranged from < .001 to .07) throughout the 15-year period. These 15-year results indicate that immediate loading of a single oxidized surface implant used to retain a mucosa-borne overdenture is a safe, reliable, and cost-effective treatment with high levels of patient satisfaction long term.

Effect of Densah Burs on Primary and Secondary Stability of Immediately Loaded Implants in Addition to Crestal Bone Loss and Gingival Probing Depth - An Evaluative Study.

Osseodensification (OD) compaction increases primary stability by leaving the residual bone particles in the osteotomy site, which in turn act as an autograft. [ 1 ] Condensing the bone trabeculae through OD has demonstrated to have a potentiating influence on secondary stability. [ 2 ]. A split-mouth study was conducted in 40 patients to determine the effect of OD on implant success rate in terms of primary and secondary stability in situations including immediate loading of implants placed in low-density bone, which was tested using resonance frequency analysis (RFA) at the interval of 0, 6 th month. In order to assess the implant success rate, gingival probing depth and crestal bone loss (CBL) around the implant were also assessed at baseline and 6 months. With respect to primary stability, at baseline, the mean RFA of Densah burs is 71.6 ± 9.5 and of conventional drills is 67.6 ± 10.4. The mean stability of Densah burs is significantly higher than conventional drills, both at baseline and after 6 months as well. CBL, at baseline, the mean CBL of Densah burs is 0.58 ± 0.11 and of conventional drills is 0.64 ± 0.12. The mean CBL of Densah burs is significantly lower than that of conventional drills for both. The implant stability values found in the present study were remarkable when compared between OD and conventional osteotomy techniques. Decreased loss of bone at the crest probing depth also aided in the increased success rate.

Cortico-basal Implants – The Ultimate Rescuer

Immediately loaded, implant supported prosthesis is a novel advancement in oral implantology. Corticobasal implants has the versatility and durability with reduced treatment time. These implants work on the principle of osseo-fixation, however, osseointegration of the implants eventually happens over a time period. Cortico-basal implant supported prostheses came to the rescue, in our following cases, where a corticobasal implant was placed in between 2 fractured, well osseo-integrated conventional implants. Another case with large periapical cyst encroaching into the right maxillary sinus floor eneucleated with the involved teeth leading to an oro-antral communication, closed surgically. Cortico-basal implants were placed bypassing the right sinus floor to restore the function. In another case of failed multiple endodontically restored teeth and even endosseous implants, cortico-basal immediate loading prostheses were placed to successfully restore both the jaws. Cortico-basal implant supported prostheses is a graft less procedure with minimized chair side time, having optimum peri-implant soft tissue health, durable, with high success rate and are gradually emerging as a promising alternative in dental rehabilitation cases. Strategic implant placement of the cortico-basal implants has proved to be the ultimate rescuers in certain circumstances. Keywords: Corticobasal, Endosseous, Implants, Osseofixation, Osseointegration.

Effects of immediate loading directionality on the mechanical sensing protein PIEZO1 expression and early-stage healing process of peri-implant bone

BackgroundThe reduced treatment time of dental implants with immediate loading protocol is an appealing solution for dentists and patients. However, there remains a significant risk of early peri-implant bone response following the placement of immediately loaded implants, and limited information is available regarding loading directions and the associated in vivo characteristics of peri-implant bone during the early stages. This study aimed to investigate the effects of immediate loading directionality on the expression of mechanical sensing protein PIEZO1 and the healing process of peri-implant bone in the early stage.MethodsThirty-two implants were inserted into the goat iliac crest models with 10 N static lateral immediate loading applied, followed by histological, histomorphological, immunohistochemical, X-ray microscopy and energy dispersive X-ray spectroscopy evaluations conducted after 10 days.ResultsFrom evaluations at the cellular, tissue, and organ levels, it was observed that the expression of mechanical sensing protein PIEZO1 in peri-implant bone was significantly higher in the compressive side compared to the tensile side. This finding coincided with trends observed in interfacial bone extracellular matrix (ECM) contact percentage, bone mass, and new bone formation.ConclusionsThis study provides a novel insight into the immediate loading directionality as a potential influence factor for dental implant treatments by demonstrating differential effects on the mechanical sensing protein PIEZO1 expression and related early-stage healing processes of peri-implant bone. Immediate loading directions serve as potential therapeutic influence factors for peri-implant bone during its early healing stage.

Immediate Versus Non-immediate Loading Protocols for Reduced-Diameter Implants Supporting Overdentures: A Systematic Review and Meta-analysis.

To compare the influence of immediate loading (IL) and non-immediate loading (NIL) protocols on overdentures retained by reduced-diameter implants (≤ 3.5 mm). Electronic databases including MEDLINE (via PubMed), Embase, and the Cochrane Central Register of Controlled Trials were searched for randomized controlled trials (RCTs) comparing clinical outcomes of immediately loaded and non-immediately loaded reduced-diameter implants supporting overdentures. The risk of bias within and across the studies and the certainty of evidence were assessed by RoB 2.0 and GRADE, respectively. A sensitivity analysis was performed by eliminating studies at high risk of bias and repeating the data synthesis employing the random effects model. Subgroup analyses were conducted based on the implant diameter and the length of follow-up. Overall, six RCTs with 255 patients were included in this systematic review. The meta-analyses found similar implant survival rates between immediately loaded and non-immediately loaded implants in the mini-implant (RR &#61; 0.98; 95% CI &#61; 0.95, 1.01; P &#61; .12) and narrow-diameter implant subgroups (RR &#61; 0.99; 95% CI &#61; 0.94, 1.03; P &#61; .56) as well as in short-term (RR &#61; 0.98; 95% CI &#61; 0.97, 1.00; P &#61; .11) and long-term (RR &#61; 0.97; 95% CI &#61; 0.93, 1.01; P &#61; .09) follow-up subgroups. Additionally, marginal bone loss (MBL) showed no statistically significant difference between the loading protocols in the subgroup of long-term follow-up (MD &#61; 0.03; 95% CI &#61; -0.16, 0.23; P &#61; .74). Three RCTs investigating peri-implant parameters found relatively higher modified plaque index (PI) and probing depth (PD) in reduced-diameter implants under IL. Compared with NIL, the IL protocol can achieve comparable survival rates and MBL in reduced-diameter implants supporting overdentures.

Outcomes of Immediately &amp; Conventionally Loaded Dental Implants

Clinical dentistry has been subjected to a revolution by introduction of “Osseo integrated” dental implants. New trends have always been of keen interest in “implant prosthodontics”. The aim behind this systematic review was to assimilate the outcomes of “immediately” &amp; “conventionally” loaded implants. To do so a detailed electronic search was performed on PubMed, Science Direct &amp; Research gate to identify pertinent articles published between 2000 to 2021. After detailed scrutiny, six studies met the preset eligibility criteria &amp; hence were shortlisted for this project. As far as the results were concerned, no remarkable difference was seen between the success of “immediately” &amp; “conventionally” loaded implant groups. There was no remarkable difference in marginal bone levels, masticatory efficiency, bleeding on probing, implant stability quotients, peri-implant soft tissue contours among both the groups provided that immediately loaded implants had significant primary stability. In selected patients “immediate loading protocol” can successfully be practiced ensuring that adequate primary implant stability has been achieved. Cochrane Review number: COCHRANEPHAHS-2022-00152

Aesthetic Outcome and Patient Perception of Immediate vs. Delayed Loading of Implant-Supported Single Crowns: A Randomized Controlled Trial

ABSTRACT Background: This randomized controlled trial aimed to compare the aesthetic outcome and patient perception of immediate versus DL of implant-supported single crowns. Methods: A total of 60 patients with a single missing tooth were enrolled and randomly assigned to two groups: immediate loading (IL) and delayed loading (DL). Each group consisted of 30 patients with a total of 30 implants. In the IL group, crowns were loaded onto implants immediately after placement, while in the DL group, a healing period of 3 months was observed before crown placement. Aesthetic outcome was assessed using the Pink Esthetic Score (PES) for soft tissue and the White Esthetic Score (WES) for the crown. Patient perception was evaluated through a visual analog scale (VAS) for satisfaction, comfort, and overall experience. Results: The IL group demonstrated comparable aesthetic outcomes to the DL group, with mean PES and WES scores of 10.2 ± 1.5 and 8.7 ± 1.2, respectively, in the IL group, and 10.5 ± 1.3 and 8.5 ± 1.4 in the DL group. Patient perception in terms of satisfaction, comfort, and overall experience was similarly high in both groups, with VAS scores above 8 for each parameter. Conclusion: This randomized controlled trial suggests that both IL and DL of implant-supported single crowns result in favorable aesthetic outcomes and high levels of patient satisfaction.

Posterior single implants immediately loaded using one abutment at one time and temporary abutment in the posterior mandible without bone augmentation: A report on six-month outcomes data obtained from a prospective randomized controlled split-mouth clinical trial

Background/Aim. Given that frequent manipulation of the abutment during immediate loading can have a negative impact on the surrounding peri-implant hard and soft tissues, the concept ?one abutment at one time? (OAO) has been introduced and documented in daily clinical practice. The aim of the study was to evaluate changes in peri-implant bone levels, clinical and radiographic parameters, and patient perspectives during the six-month follow-up period. Methods. The study was designed as a randomized controlled clinical trial. Patients with bilaterally healed sites in the posterior mandible received implants with a diameter of no less than 3.5 mm and a length of at least 8 mm. Based on randomization, patients were divided into a test group and a control group. Patients who were in the test group received implants that were immediately loaded with definitive abutments. In contrast, patients in the control group received implants where healing abutments were placed, followed by temporary abutments. Implants were immediately loaded with provisional restorations within the first seven days. They were delivered over the test group?s definitive abutment and the control group?s temporary abutment. Probing depth, bleeding on probing, clinical attachment level, plaque index, and keratinized tissue width were measured. Patient-Reported Outcome Measures and the Oral Health Impact Profile - 19 (OHIP-19) questionnaires were noted. Results. Out of 24 included patients, 22 completed the six-month follow-up. Peri-implant bone loss between study groups was comparable (mesial: t = -0.798, df = 21, p = 0.434; distal: t = 1.688, df = 21, p = 0.106), without statistical inter-group significance. OHIP-19 total scores significantly decreased after three months and remained similar six months after the implant placement in both groups without statistically relevant clinical inter-group changes. Conclusion. The OAO approach and provisional abutments showed comparable effectiveness regarding the immediate loading of posterior single implants.

Early complications and quality of life in patients with immediately loaded implant-supported maxillary partial rehabilitations: A prospective cohort study.

Immediate loading of dental implants is considered an excellent option to reestablish function and aesthetics in a short period of time, thereby reducing the psychological impact of edentulism. The aim of this study was to describe the incidence of complications in immediately loaded implant-supported single or partial maxillary provisional rehabilitations; to assess changes in patient quality of life (QoL); to evaluate patient overall satisfaction; and to determine whether the occurrence of complications affects these outcomes. Patients requiring partial rehabilitation with implants in the maxilla were included in a prospective cohort study. In all cases, implant-based restoration with an immediate loading protocol was indicated. A provisional restoration was placed within 72 hours after implant placement. Patient QoL was measured at the first appointment and just before placing the final restoration, using two validated questionnaires. All mechanical and biological complications occurring up until placement of the final restoration were documented. A descriptive and bivariate analysis of the data was performed. Thirty-five patients with 40 prostheses supported by 60 implants were analyzed. Three implant failures were observed, yielding a 95% survival rate. Five provisional prosthesis fractures and two prosthetic screw loosenings were recorded in four patients. A significant reduction in OHIP-14 score was observed. Likewise, significant differences were found in the results of the QoLFAST-10, with a mean difference in score of 7.3 between the initial and final evaluation. Patients receiving immediately loaded implant-supported single or partial maxillary provisional rehabilitations seem to have a low risk of developing early mechanical (13.3%) or biological complications (5%). These patients appear to experience significant improvement in QoL and report excellent overall satisfaction with the treatment received - though the occurrence of complications seems to affect these outcomes.