Immediately Loaded Research Articles

Implant loss and crestal bone loss in early loading versus delayed and immediate loading in edentulous mandibles. A systematic review and meta-analysis.

BackgroundInformation about the risk of early loss and crestal bone loss of dental implants which have been loaded early is scant if compared with data available for those conventionally or immediately loaded. A meta-analysis of early loss and crestal bone loss in immediate or delayed loaded full mandibular denture retaining dental implants has been recently published. It is interesting to evaluate also the risks of early versus immediate and delayed loading in complete mandibular restorations. The purpose of this systematic review and meta-analysis was to study early (EL) versus immediate (IL) and delayed loading (DL) protocols in edentulous mandibles to determine whether differences exist in implant success and crestal bone loss. Material and MethodsThe literature review was conducted in PubMed, Web of Science, and the Cochrane Library. Seven randomized clinical trials were included. ResultsThe result of a meta-analysis of implant loss before 1 year in EL versus IL was 0.34 (95% CI: 0.08, 1.52), favoring the EL control group, while the outcome for crestal bone loss at the three-year observation was -0.10 (95% CI: -0.28, 0.09), with a tendency toward reduced bone loss for EL. In the EL versus DL group, the result of the meta-analysis of implant loss before one year was inconclusive, while in the comparison regarding crestal bone loss in the first year of observation, the result was -0.03 (95% CI: -0.08,-0.02) with a tendency to less bone loss in EL. ConclusionsThe risk of early implant loss in the IL group was higher than in the EL group. The results in terms of early implant loss in EL versus DL are inconclusive. Besides, crestal bone loss is greater in immediately and delayed loaded implants, at 1 and 3 years of observation, compared to those loaded early. Key words:Dental implants, early dental implant loading, dental prostheses, implant- supported, alveolar bone loss, meta-analysis.

Dynamic navigation guided surgery and prosthetics for immediate loading of complete-arch restoration.

To assess clinical and radiological performance of novel digital workflow integrating dynamic guided surgery, to streamline execution of implant placement, soft and bone tissue sculpturing, and immediate delivery of navigation guided complete-arch prosthesis. This proof of concept prospective single cohort study investigated 10 consecutive patients (three males, seven females; mean age 62.5 ± 8.9 years; range, 48-75) requiring at least one complete-arch fixed dental prostheses (FDP) in both jaws, treated between January and August 2019. Primary outcomes were implant and prosthetic success rates, surgical and prosthetic complications. Secondary outcomes were marginal bone loss (MBL), implant stability quotient (ISQ), periodontal parameters (plaque and bleeding indexes). Sixty implants (32 NobelParallel TiUltra and 28 NobelActive TiUltra, Nobel Biocare) were placed and 14 complete-arch FDPs immediately loaded (mean follow-up 16.2 ± 1.7 months, 14-18). One implant failed and was immediately replaced. No other surgical or biological complications occurred, accounting for a cumulative success rate of 98.3%. No prosthetic complication occurred, leading to 100% prosthetic success rate. Mean ISQ at implant placement was 71 ± 2.8 (65-78). The mean MBL was -0.53 ± 0.28 mm (-0.22 to -1.12 mm). Plaque and bleeding scores were 14.4 ± 8.18 and 7.15 ± 4.4, respectively. Within the limitations of this proof-of-concept dynamic navigation was effective to deliver in the planned coordinates both implants and prosthesis and guide bone and soft tissue sculpturing. Immediate loading of digitally prefabricated esthetically driven complete-arch FDP was facilitated, resulting in high implant and prosthetic success rates. The investigated digital workflow integrating dynamic navigation may overcome the difficulties related to immediate positioning and loading of digitally prefabricated complete-arch FDP. The navigation guided soft and bone tissues sculpturing, associated to xenogeneic collagen matrix grafting, represented a predictable technique to achieve the digitally planned interface, reestablishing the mucosal dimension required for the protection of underlying bone while maintaining tissue health.

Comparison of immediate and delayed loading of dental implants in mandibular posterior teeth: Clinical observations and review

Introduction: The study is aimed to compare the clinical outcome of immediate and delayed loaded single tooth implants in replacement of mandibular posterior tooth in consideration with implant stability quotient, bleeding on probing, probing depth, implant mobility, marginal bone loss and peri-implant radiolucency. Materials and Methods: The study consisted of 20 patients who were divided into two groups and compared: Group A is an immediately loaded group with ten patients who received implants in the mandibular posterior tooth region along with abutment on the same day and acrylic crown placed within 48 h and the second group is a conventionally loaded group of ten patients who received the implant in the mandibular posterior tooth region in which the cover screw was placed and conventionally loaded after 3 months. Implant stability quotient, implant mobility, bone loss and peri-implantitis were assessed at 1st and 6th months after loading. All patients were evaluated for the parameters at 1st, 3rd and 6th months after loading in both the groups. Results: Probing depths obtained for all twenty patients after 1 and 6 months of loading were within the normal range (1–3 mm). In Group A, the mean probing depth after 1-month loading was 1.8 mm with a standard deviation (SD) of 0.63 and after 6 months of loading 1.2 mm with SD 0.42. In Group B, the mean of the probing depth after 1 month of loading is 1.8 mm with SD 0.42 and remained the same post loading after 6 months. Marginal bone loss was measured mesially and distally after 1 month and 6 months in both the groups. The standard intraoral periapical radiograph was used to evaluate peri-implant radiolucency. No patient showed peri-implantitis for 6-month follow-up after loading of implants. Conclusion: Immediate loading of an implant in a single mandibular posterior tooth can be an effective treatment modality and a promising alternative to delayed loading.

Clinical success between tilted and axial implants in edentulous maxilla: A systematic review and meta-analysis.

Aim:This systematic review and meta-analysis evaluated the clinical survival of axial and tilted implants in atrophic edentulous maxilla after three years of immediate loading and also the corresponding marginal bone loss.Setting and Design:This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PRISMA).Materials and Methods:The relevant studies were retrieved from MEDLINE(PubMed), the Cochrane Central Register of Controlled Trials (CENTRAL), Science Direct, Google Scholar databases. The search was limited to studies published in the English language with no date restrictions. A further hand search was conducted on individual journals and reference lists of studies. The risk of bias in included studies was assessed by using the Evidence Project risk of bias tool.Statistical Analysis Used:Statistical meta-analysis was conducted using RevMan 5.4 software. The assessment for the level of evidence was done using GRADEpro software.Results:Eleven studies were finalised. All were included in the meta-analysis for implant survival, while only seven studies were included in the meta-analysis of marginal bone loss. After three years, the meta-analysis results for implant survival showed no statistical difference between axial and tilted implants, with the forest plot neither favouring axial nor tilted implants (RR = 1.00 (95% CI: 0.98-1.01); P-value = 0.59). After three years, the meta-analysis results for marginal bone showed no statistical difference between axial and tilted implants, with the forest plot neither favouring axial nor tilted implants (MD = -0.02; 95% CI; -0.09-0.06; P-value = 0.69).Conclusion:In the immediately loaded rehabilitation of completely edentulous atrophic maxillae, tilting of implants did not induce any significant alteration in their survival and their corresponding marginal bone loss levels compared to conventionally placed axial implants even after three years of function.

5-year randomized multicenter clinical trial on single dental implants placed in the midline of the edentulous mandible.

This multicenter randomized controlled clinical trial was conducted to investigate whether the loading protocol of single dental implants placed in the midline of edentulous mandibles will influence the implant survival or prosthetic maintenance. In total, 158 patients were randomly assigned either to the immediate loading group (n=81) or to the delayed loading group (n=77). All implants were loaded with an overdenture retained by a ball attachment. After 5years, 102 patients attended the follow-up investigation. Immediately loaded single implants in the midline of the edentulous mandible revealed a statistically significant lower survival rate than implants loaded conventionally over an observation period of 5years. In the immediate loading group, 9 implants failed within the first three months of implant loading. No further implant loss was recorded for this group. Two implants failed in the delayed loading group, whereas one implant had to be removed during second-stage surgery and the second five years after implant loading. Non-inferiority of the survival rate of the midline implant of the immediate loading group, compared with the delayed loading group, could not be shown (p=.79, CI immediate loading: 74.9%; 100.0%, CI delayed loading: 73.0%; 100.0%). The observed difference in implant survival between the two treatment groups over time was statistically significant. The results of the present study indicate that immediate loading of a single mandibular implant in the edentulous mandible should be considered only in exceptional cases.

Long-Term Retrospective Study of 3.0-mm-Diameter Implants Supporting Fixed Multiple Prostheses: Immediate Versus Delayed Implant Loading.

Narrow dental implants are commonly used to restore narrow alveolar ridges. Although the good performance of narrow dental implants supporting multiple prostheses has been repeatedly demonstrated, there are few studies analyzing their performance in a long-term follow-up together with the influence of the loading protocol. Thus, the objective was to assess the influence of implant loading protocol (immediate vs delayed) on the long-term outcomes of 3.0-mm-diameter dental implants supporting fixed multiple prostheses. This retrospective cohort study included 202 3.0-mm-diameter dental implants supporting multiple prostheses placed between January 2006 and April 2009. Immediate loading was performed when the implants were inserted in bone types I, II, and III and achieved an insertion torque ≥ 25 Ncm; otherwise, delayed loading was performed. The survival of the dental implants was recorded together with clinical and demographic information of the participants. The prosthetic complications (ceramic chipping, screw loosening, screw fracture, decementation, prosthesis failure) were also recorded. The marginal bone loss since insertion and the marginal bone loss since loading were calculated. Delayed implant loading was performed in 131 implants and immediate loading in 71 implants. The follow-up time was 106 ± 40 months and 117 ± 38 months in the delayed and immediately loaded implants, respectively. The implant loading protocol (delayed vs immediate) showed no influence on the implant survival rate (96.2% vs 97.2%) and the marginal bone loss since insertion (1.2 ± 1.0 mm vs 1.2 ± 1.0 mm). The implant loading protocol (immediate vs delayed) did not influence the long-term outcomes (survival and marginal bone loss) of 3.0-mm-diameter dental implants supporting fixed multiple prostheses. These results are in favor of considering immediately loaded narrow dental implants as a viable treatment alternative for horizontally resorbed ridges. Nevertheless, future randomized clinical trials are needed to confirm these observations.

Zygomatic Implants for the Rehabilitation of Atrophic Maxillae: A Retrospective Study on Survival Rate and Biologic Complications of 206 Implants with a Minimum Follow-up of 1 Year.

To carry out a retrospective analysis of the placement of zygomatic implants in atrophic maxillae and to assess the outcomes in terms of survival rate and biologic complication incidence, with a follow-up of at least 1 year and in 13% of cases, longer than 5 years. The study included all patients rehabilitated through zygomatic implant surgery from 2006 to 2017 and excluded those treated in 2018 to guarantee a minimum follow-up of 1 year. Depending on the specific case, one, two, or three zygomatic implants were placed in combination with conventional implants, or four zygomatic implants were placed alone (zygoma quad). All implants were placed by the same surgeon in a private clinic through an anatomy-guided surgical approach and were immediately loaded with screwed provisional prostheses up to the end of the osseointegration phase. Patients who did not undergo any or the last follow-up visits were not included in order to assess the real conditions of implants, soft tissues, and maxillary sinuses in the last year of follow-up (2018). A total of 206 zygomatic implants were placed in 102 patients. There were only two failures due to a lack of osseointegration (0.97%): in one case, 3 months after placement and in the other one, 2 years after placement. There were five cases of sinusitis (2.42%), two of which also presented oroantral communication (0.97%); in three cases, antibiotic and conservative treatments alone were not effective, so the removal of the zygomatic implant was necessary. Finally, two cases of mucosal recession (0.97%) appeared in two anterior zygomatic implants. The global survival rate was 97.57%, and all biologic complications are currently stable. In this study, the rehabilitation of atrophic maxillae through zygomatic implants was shown to be a predictable treatment, which allows a graftless approach and makes it possible to carry out immediate loading protocols, with enormous psychologic advantages for patients. Survival rates are high, and complication incidence is low. Thus, at present, zygomatic implants may be considered a reliable treatment option in the case of severe atrophic maxillae.

Effect of Different Immediate Implant Loading Protocols on Peri-implant Soft Tissue Health

Objective:This clinical study was conducted to evaluate the effect of immediate loading on peri-implant soft tissue health using three protocols: i) Immediate functional loading using polymer infiltrated ceramic (PIC) material (IFLV). ii)Immediate functional loading using polymethyl methacrylate (PMMA) followed by delayed functional loading using PIC material (IFLP). iii) Immediate non-functional loading using PMMA followed by delayed functional loading using PIC material (INFLP). Material & Methods: 30 Implants were placed in the upper premolar area and divided randomly according to the immediate loading protocol. In the control group (INFLP), CAD/CAM PMMA crowns were placed out of occlusion for 3 months, and then replaced by CAD/CAM VITA ENAMIC crowns in functional occlusion. For (IFLV) group, CAD/CAM VITA ENAMIC crowns were immediately loaded in functional occlusion; while in (IFLP) group, CAD/CAM PMMA crowns were placed in functional occlusion for 3 months, and then replaced by CAD/CAM VITA ENAMIC crowns. Modified pink esthetic score (MPES) and probing depth were used for evaluation of peri-implant soft tissue at base line and follow up periods. Results: INFLP showed higher MPES results compared to IFLV and IFLP. Moreover, the INFLP probing depth at 3 months showed higher results compared to the other groups. Conclusions: Immediate non-functional loading showed the best outcomes. However, peri-implant soft tissue health of the immediate functional loading using the PIC crown material was clinically acceptable.Key WordsPolymer infiltrated ceramics, immediate dental implant loading, peri-implant soft tissue health.

Immediate Loading of Single Implants, Guided Surgery, and Intraoral Scanning: A Nonrandomized Study.

To compare clinical and esthetic outcomes between immediately loaded single implants placed with and without a fully guided surgical procedure. Patients with a missing maxillary tooth (second premolar to second premolar) were considered for inclusion in this 1-year prospective nonrandomized study. Exclusion criteria were general health contraindications for oral surgery besides the need for bone grafting or ridge augmentation. One group received digital implant planning, fully guided surgery, and immediate loading (DIL). The other group received freehand surgery and immediate loading (IL). Outcome measures were implant survival, marginal bone loss, soft tissue changes, papilla index, pink and white esthetic scores (PES and WES, respectively), and patient-reported outcome measures (PROMs). Two of 21 implants failed in the DIL group soon after placement, resulting in a 1-year implant survival rate of 90.5%, while no implants failed in the IL group. Significantly higher papilla index scores and lower soft tissue changes were found for the DIL group compared to the IL group. No differences were found after 1 year regarding marginal bone loss, PES, WES, or PROMs. Within the limitations of this study, immediate loading in combination with fully guided surgery might negatively affect implant survival. Immediate loading, fully guided surgery, and a digital workflow appear to have a positive effect on early soft tissue adaptation.

A Technique to Fabricate an Interim Implant-Supported Fixed Complete Denture for Immediate Loading.

Converting an acrylic resin removable complete prosthesis into a fixed implant-supported prosthesis to immediately load the implants can be a challenging procedure. Using acrylic resin to secure titanium interim copings intraorally may be a difficult task, and any process to facilitate this procedure may be advantageous for the clinician and the patient. This report describes a technique for facilitating the fabrication of an interim immediately loaded implant-supported fixed complete prosthesis. This technique and the materials used enabled the efficient fabrication and delivery of the prosthesis with an appropriate soft-tissue surface and acrylic resin thickness without irritating newly sutured soft tissues.

Immediately loaded mini-implants supporting mandibular overdentures: A one-year comparative prospective cohort study.

Little is known about differences between mini-implants and conventional immediately loaded implants for overdentures. To compare clinical outcomes using two immediately loaded conventional or mini-implants for mandibular overdentures. Edentulous patients receiving either conventional (4.1 mm) or mini-implants (2.9 mm or less), based on available bone width were analyzed. All implants were immediately loaded with mandibular overdentures installed using locator attachments. Digital periapical radiographs for measuring marginal bone loss and clinical outcomes (ie, periodontal probing, plaque, and bleeding indices) were assessed at 1, 3, 6, and 12-month follow-up periods. Fifty patients (25 receiving conventional implants-12 females, mean age of 65.3 ± 7.3 years; and 25 receiving mini-implants-11 females, mean age of 66.8 ± 8.1 years) was analyzed. Peak insertion torque (P = .001) and bone loss (P = .02), as well as change in plaque (P = .02) and bleeding (P = .04) indices at 12 months differed significantly between groups. Furthermore, linear regression revealed the height of the locator as a risk factor for bone loss (P = .038). The present findings suggest that two mini-implants are significantly more susceptible to bone loss after immediate loading, for which the height of locator might be considered a risk factor.

Radiographic evaluation of crystal bone level of immediate loaded implant restored with two different CAD-CAM materials

Purpose This study was conducted to radiographically evaluate the effect of two different superstructure CAD/CAM fabricated materials, on crestal bone loss around immediately loaded implant. Materials and Methods A total of twelve healthy patients having mandibular bilateral missing first molars with acceptable bone volume were selected based on specific inclusion and exclusion criteria, each patient received a CAD/CAM monolithic zirconia, in one site, while the other site received a CAD/CAM Enamic superstructure, in 48 hours after implant insertion. Implants and abutments were examined for stability, gingival and periodontal health prior to crown cementation. Radiographic evaluation was done immediately at the time of crown cementation then at 6 and 12 months. Results Marginal bone loss was measured at two points, the most buccal crestal bone, and the most lingual crestal bone. Radiographic results showed no significant difference regarding mean MBL between Zirconia and Enamic on 6 and 12 months. Conclusion Immediate loading of a single mandibular molar implant with the final restoration seem to be a reliable technique when certain parameters are respected. Type of implant superstructure material has no significant influence on the bone supporting the implant within the time period of this study.

Immediate vs conventional loading of Facility-Equator system in mandibular overdenture wearers: 1-year RCT with clinical, biological, and functional evaluation.

The use of immediate loading (IML) is still poorly explored in elderly patients and implant-retained mandibular overdenture (IMO) wearers. For this reason, more comparisons to conventional loading (CL) are required. To evaluate the clinical, biological, functional, and oral health-related quality of life (OHRQOL) influence of CL and IML loading on elders wearing IMO retained by the Facility-Equator system up to 1 year after implant installation. Twenty edentulous patients received two narrow diameter implants in the mandible; the loading type (CL or IML) was randomized. The clinical parameters were monitored along with prosthetic events, marginal bone loss (MBL) and bone level change (BLC), implant stability quotients (ISQ), masticatory performance outcomes, and Interleukin 1 beta (IL-1β) and tumor necrosis factor alpha (TNF-α) levels in the peri-implant crevicular fluid during the first year of loading. The OHRQoL was assessed via the Oral Health Impact Profile-EDENT questionnaire. Data were analyzed by the Mann-Whitney, χ2 , Wilcoxon paired, and McNemar tests. After 1 year, MBL, BLC and ISQ were statistically identical (P > .05) in the CL and IML groups. The probing depth at 12 months in the CL group (2.19 mm) was higher than in the IML group (1.29 mm; P ≤ .0001). TNF-α was 33.6% higher in the CL group at 6 months (P = .043), while IL-1β was significantly higher in the IML group up to 6 months. The survival rate was 90% in the CL group and 85% in the IML group; 33 prosthetic events occurred in CL group and 23 in IML group. After 12 months, both loading protocols are viable and result in similar clinical, biological, functional, and OHRQOL outcomes. However, IML generates better adaptation of the peri-implant tissues, faster improvement in OHRQoL and fewer prosthetic intercurrences than CL.

Periodontal Evaluation of One-Piece and Two-Piece Single Implant Loaded in Esthetic Zone

Background: Soft tissue around dental implant is an important anatomical feature contributing to the long-term implant success and esthetics, different factors may influence the soft tissue-implant interface. The purposes of the current study were to evaluate the soft tissue profile around one-piece and two-piece implants loaded in esthetic zone. Method: Totally thirty patients who had single missing tooth in premaxillary region were included in the study. Fifteenth patients’ group-A were assigned to immediate loading one-piece implant and fifteen patients’ group-B were assigned to early loading two-piece implant protocol. Flapless approach was performed for both groups. In group-A, implants were loaded immediately with a temporary crown within 48h, while group-B, were loaded after two months following conventional impression for metal ceramic crown. Clinical outcomes were evaluated after two and six months in terms of success rate, papillary index, plaque index and width of keratinized mucosa. Results: The success rate in group-A found to be 80%, which was lower than the success rate in group-B (100%). On comparison, there was no statistically significant difference in success rate between the two study groups. There was no statistically significant difference between both groups over time in clinical parameters like plaque index, width of keratinized gingiva and papillary index. Conclusion: The results of this study indicated that using either immediately loading one-piece implants or early loaded two-piece implants protocol demonstrated the same enhancements of implant esthetics

Peri‐implant myelinated nerve fibers: Histological findings in dogs

While osseointegration following various dental implant placement protocols has been extensively investigated, the neurohistological integration has received little attention. The primary aim of this study was to compare the myelinated nerve fibers density in peri-implant bone tissue following various implant placement protocols. The secondary aim assessed the effect of follow-up on peri-implant nerve fibers density. Ten beagle dogs randomly received 68 commercially pure titanium implants in the mandibular premolar or molar regionbilaterally following extraction utilizingone of the six treatment protocols: (a) immediate implant placement (IIP) and immediate loading (IL); (b) IIP and delayed loading (DL); (c) IIP and left unloaded (UL); (d) delayed implant placement (DIP) and IL; (e) DIP and DL; and (f) DIP and UL. Histomorphometric analysis of the peri-implant myelinated nerve fibers was performed in a 300μm peri-implant zone at the cervical, middle, and apical level following implant placement. The follow-up assessment involved longitudinal observation at 3months following each implant treatment protocol and at 6months for IIP+IL and IIP+DL protocols. The influence of different treatment protocols, including the fixed effects of implant groups (IIP+IL, IIP+DL, IIP+UL, DIP+IL, DIP+DL, DIP+UL) and regions (cervical, middle, apical), was examined via a linear mixed model. The IIP+IL group showed a significantly higher myelinated nerve density compared to the IIP+UL and DIP+UL group. Peri-implant nerve re-innervation was significantly higher (P=.002) in the apical region compared to the cervical region. After immediate implant placement, the IL group showed a significantly (P=.03) higher density of myelinated nerve fibers compared to DL. No significant (P=.19) effect of follow-up on nerve density was observed. The immediate implant placement and loading protocol showed most beneficial effect on peri-implant innervation with highest myelinated nerve density in the apical region. A longer loading time had no influence on the peri-implant nerve density.

Tightening and Loosening of the Abutment Screw Negatively Affects Implant Osseointegration in the Early Healing Stage in Rat Tibiae.

To examine the effect of tightening and loosening the dental implant screw on implant osseointegration in an elderly rat model. Titanium dental implants were inserted in the bilateral tibiae of 34 elderly Wistar rats (1 year and 3 months old). Rats were randomly divided into five groups: control (no loading); immediate loading (IL) (vertical load [3 Hz for 15 minutes/day] immediately after implantation); early loading (EL) (load started on postoperative day 7); five times abutment removal (R5) (tightening and loosening of the abutment screw once per day for 5 days each week); and two times abutment screw removal (R2) (tightening and loosening of the abutment screw once per day for 2 days each week). After 4 weeks, the rats were euthanized, and the bone structure surrounding the dental implants was evaluated using microcomputed tomography analysis. Osseointegration failed more frequently in the EL, R2, and R5 groups than in the control and IL groups (P = .06). The EL, R2, and R5 groups also tended to have lower relative gray values than the control and IL groups. Tightening and loosening the abutment screw might negatively affect dental implant osseointegration in the early healing stage in older adults.

Influence of orthodontic loading on biomarkers levels around miniscrews

ObjectiveThe aim of this study was to evaluate the levels of Interleukin-1α (IL-1α), Interleukin-1β (IL-1β), Interleukin-1 receptor antagonist (IL-1Ra), Interleukin-10 (IL-10), Interleukin-13 (IL-13), Vascular endothelial growth factor (VEGF), Granulocyte-colony stimulating factor (G-CSF), and Growth related oncogene (GRO) in the peri-miniscrew implant crevicular fluid (MICF) under orthodontic loading. DesignThe study sample comprised 14 miniscrews immediately loaded and 17 unloaded ones. A load of 200gF was immediately applied to the miniscrews in the loaded group after the placement surgery. Peri-miniscrew implant crevicular fluid was collected at baseline, at day 7, and at day 21. The levels of the biomarkers were measured using a multiplexed bead immunoassay. Intergroup comparisons were made using Mann-Whitney test. Friedman and Dunn's multiple comparison tests were used to evaluate intragroup differences over time. ResultsAlthough no statistical differences were observed between the groups at any time point for any of the 8 biomarkers evaluated, there was a statistically significant increase (p < 0.02) in the levels of all the biomarkers over time on both groups. ConclusionsAn immediate loading of 200gF does not alter the balance in the inflammatory response in peri-miniscrew tissues.

Complete-arch fixed reconstruction by means of guided surgery and immediate loading: a retrospective clinical study on 12 patients with 1\u2009year of follow-up

BackgroundGuided implant surgery is considered as a safe and minimally invasive flapless procedure. However, flapless guided surgery, implant placement in post-extraction sockets and immediate loading of complete-arch fixed reconstructions without artificial gum are still not throughly evaluated. The aim of the present retrospective clinical study was to document the survival and success of complete-arch fixed reconstructions without artificial gum, obtained by means of guided surgery and immediate loading of implants placed also in fresh extraction sockets.MethodsA total of 12 patients (5 males and 7 females, with a mean age of 50.0 ± 13.8) were enrolled in this study. Implant planning was performed with a guided surgery system (RealGuide®, 3Diemme, Como, Italy), from which 3D-printed surgical templates were fabricated. All implants (Esthetic Line-EL®, C-Tech, Bologna, Italy) were placed through the guides and immediately loaded by means of a temporary fixed full-arch restoration without any artificial gum; the outcome measures were implant stability at placement, implant survival, complications, prosthetic success, soft-tissue stability, and patient satisfaction.ResultsOne hundred ten implants (65 of them post-extractive) were placed flapless through a guided surgery procedure and then immediately loaded by means of provisional fixed full arches. Successful implant stability at placement was achieved in all cases. After a provisionalization period of 6 months, 72 fixed prosthetic restorations were delivered. Only 2 implants failed to osseointegrate and had to be removed, in one patient, giving a 1-year implant survival rate of 98.2% (108/110 surviving implants); 8/12 prostheses did not undergo any failure or complication during the entire follow-up period. At the 1-year follow-up control, soft-tissue was stable in all patients and showed satesfactory aesthetic results.ConclusionsWithin the limits of this study, complete-arch fixed reconstruction by means of guided surgery and immediate loading of implants placed in fresh extraction sockets appears to be a reliable and successful procedure. Further long-term prospective studies on a larger sample of patients are needed to confirm these positive outcomes.

Immediately Loaded Single Unit Dental Implants: A Clinical Study.

ABSTRACTBackground:Immediate loading of dental implants is an obvious advantage. A long treatment period that involves the wearing of a temporary prosthesis may be of great inconvenience, and is sometimes the reason for not choosing implant-supported restorations at all.Aim:In our study, an attempt was made to immediately load single tooth implants in the aesthetic zone of the dentition.Materials and Methods:Patients were selected from Government Dental College, Patna. Twenty-four single tooth implants were placed in 24 patients; 12 male and 12 female patients desiring replacement of one or more missing teeth in anterior region were selected. Surgery for the placement of the implant was carried out, and implants of the Uniti Implant System were placed. The abutment was then attached and the flap was sutured. A temporary acrylic resin crown was fabricated and cemented on the same day. Permanent prosthesis was inserted on sixth month after implant placement.Results:A clinical study was performed to evaluate the treatment outcomes of dental implants installed according to a one-stage surgical procedure followed by immediate loading with prosthesis. Of the 24 implants, 23 showed signs of successful osseointegration over a 1-year follow-up.Conclusion:Within limits of the evaluated data, it was observed that immediately loaded implants osseointegrate, so this alternative was used over conventional procedures that take 6 months for osseointegration. This has advantages, both for patient and practitioner.

Assessment of primary stability of immediate implants placed in the maxillary and mandibular anterior region using resonance frequency analysis

Background: A matter of controversy in implant dentistry concerns the most appropriate method to determine implant stability. Many methods have been reported in the literature including periotest and resonance frequency analysis (RFA). However, there is no consensus regarding the ideal method to determine implant stability. Materials and Methods: A total of 50 patients male and female in the age group of 18–38 years, each having at least one tooth indicated for extraction (either maxillary or mandibular anterior teeth) were selected. Fifty Xive implants (Friadent, Dentsply, Germany) were placed into fresh extraction sockets and immediately loaded. Implants were evaluated by clinical and radiographic methods. Implant stability was measured using periotest and RFA at the time of implant placement, 3 months, 6 months, 9 months, and 12 months postoperatively. Results: The mean mobility values for periotest decreased over a period of observation, and all implants consistently produced readings between −8 and + 7. The RFA values during the period of observation increased, and it was in the range of 49–100. Statistical analysis using regression analysis showed that percentage improvements in stability during each period were statistically highly significant in respect of periotest and RFA (P = 0.0001). Conclusions: A clinical trend of an implant stability quotient (ISQ) of more than 49 with a range of 49–98, is probably descriptive of osseointegrated implants. However, according to our experience, implants with a primary stability above 50 ISQ may be sufficient for successful immediate loading while implants below 40 could be dealt with caution and conventional loading can be considered in such cases.