Success rate of immediate nonfunctional loaded single-tooth implants: Immediate versus delayed implantation

Purpose: The aim of this study was to evaluate the success rate of maxillary immediate nonfunctional single-tooth loaded implants used into fresh extraction sites (immediate placement condition) or healed ridge (delayed placement condition).Materials and Methods: Eighty-two dental implants were placed in the maxilla of 64 consecutive patients from Private practice office and from a specialization course in Implantology. Forty-six implants were inserted under immediate placement condition, and 36 were inserted under delayed placement condition. The criteria used to evaluate success rate were those previously described by Albrektsson and Zarb (Int J Prosthodont 1993;6: 95-105), and follow-up period ranged from 18.0 to 39.7 months.Results: Seventy-nine implants fulfilled the success rate criteria (96.3%). Moreover, differences concerning implantation condition were not significant (P = 0.33, Qui-square test): three of the failed implants were from immediate placement group (success rate of 93.5%), and none was from delayed placement group (success rate of 100.0%).Conclusion: In the present sample, no statistically significant differences were detected for immediate nonfunctional single-tooth loaded implants under immediate placement condition in comparison with those inserted under delayed placement condition; both protocols had high success rate in maxillary incisors, canines, and premolars areas.

All-on-four concept and immediate loading for simultaneous rehabilitation of the atrophic maxilla and mandible with conventional and zygomatic implants

We report the simultaneous rehabilitation of an edentulous patient with a hybrid (zygomatic and conventional implants) all-on-four implant-supported prosthesis for the maxilla and a standard (conventional implants) all-on-four implant-supported prosthesis for the mandible. The transfer impression was made with a multifunctional guide and the upper and lower prostheses were placed 24 h postoperatively. Clinical and radiographic examinations showed no infection or bony resorption 2 years later. Simultaneous maxillary and mandibular rehabilitation with all-on-four immediate loading is a viable, fast and effective option for edentulous patients. (C) 2009 Published by Elsevier Ltd on behalf of The British Association of Oral and Maxillofacial Surgeons.

Immediate X delayed loading dental implants: An overview

The aim of this investigation was to accomplish an overview about the principles of the indication and of the success parameters involving immediate and delayed loading dental implants procedures. Studies about the philosophies (immediate and delayed loading dental implants) and their clinical indications will be discussed in order to overview the rules for the clinical success in both techniques. In addition, studies regarding the criteria for immediate loading implants as primary stabilization, surface treatments and bone density and amount will be also analyzed. More important than the philosophy selection, is how and when to use it according to biomechanical rules and principles. Among the vast limitations pointed by the literature regarding procedures of immediate and delayed loading are evidenced the parafunctional habits, primary stabilization, bone quality, surface treatments and the number of dental implants. The anterior region of the jaw seems to be associated with a major percentage of satisfactory results, regardless of rehabilitation procedures. Although several studies have demonstrated high success rates for the immediate loading dental implants, several aspects remain without an explicit definition and further studies are needed to elucidate some reservations.

Influence of immediate loading on healing of implants installed with different insertion torques - an experimental study in dogs

Objective: To evaluate the influence of different insertion torques on healing of implants loaded immediately or left unloaded.Material and methods: In six Labrador dogs, all mandibular premolars and molars were extracted. After 4 months of healing, flaps were elevated, and two implant sites were prepared at each side of the mandible. The distal sites were prepared conventionally while the mesial sites were underprepared by 0.3 mm. As a consequence, different final insertion torques of about 30 Ncm at the distal and >70 Ncm at the mesial sites were recorded. Healing abutments were applied to the left and transmucosal abutments to the right side. Flaps were sutured, crown preparation of the upper right second and third premolars was performed, and impressions were taken. Within 24 h, crowns were cemented both to implants and teeth in the right side of the mouth. After 4 months, the animals were sacrificed and ground sections obtained for histological evaluation.Results: A higher buccal bony crestal resorption and a more apical position of the coronal level of osseointegration were found at the loaded compared with the unloaded sites. MBIC% and percentages of peri-implant mineralized tissue (MB%) were higher at the loaded compared with the unloaded sites. Moreover, a higher MBIC% was found at the lower compared with the higher final insertion torque.Conclusions: Immediate loading does not seem to have a negative effect on osseointegration. High torque values for the immediate loading procedures were not necessary. Probably, low torque values, were sufficient to obtain primary stability and hence may provide better osseointegration than high torque value.

Bone-implant contact around crestal and subcrestal dental implants submitted to immediate and conventional loading

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Immediate loading of implants installed in a healed alveolar bony ridge or immediately after tooth extraction: an experimental study in dogs

ObjectiveTo compare the sequential healing at immediately loaded implants installed in a healed alveolar bony ridge or immediately after tooth extraction.Material and methodsIn the mandible of 12 dogs, the second premolars were extracted. After 3months, the mesial roots of the third premolars were endodontically treated and the distal roots extracted. Implants were placed immediately into the extraction sockets (test) and in the second premolar region (control). Crowns were applied at the second and third maxillary premolars, and healing abutments of appropriate length were applied at both implants placed in the mandible and adapted to allow occlusal contacts with the crowns in the maxilla. The time of surgery and time of sacrifices were planned in such a way to obtain biopsies representing the healing after 1 and 2weeks and 1 and 3months. Ground sections were prepared for histological analyses.ResultsAt the control sites, a resorption of the buccal bone of 1mm was found after 1week and remained stable thereafter. At the test sites, the resorption was 0.4mm at 1-week period and further loss was observed after 1month. The height of the peri-implant soft tissue was 3.8mm both at test and control sites. Higher values of mineralized bone-to-implant contact and bone density were seen at the controls compared with the test sites. The differences, however, were not statistically significant.ConclusionsDifferent patterns of sequential early healing were found at implants installed in healed alveolar bone or in alveolar sockets immediately after tooth extractions. However, three months after implant installation, no statistically significant differences were found for the hard- and soft-tissue dimensions.

Evaluation of single implants placed in the posterior mandibular area under immediate loading: a prospective study

The aim of this study was to evaluate the survival of single dental implants subjected to immediate function. Twelve patients with edentulous areas in the posterior mandible were included in the study. All received at least one regular platform dental implant (3.75mm×11mm or 3.75mm×13mm). Clinical and radiographic parameters were evaluated. The survival rate after 12 months was 83.3%. The implants showed no clinical mobility, had implant stability quotient values (ISQ; Osstell) around 70, bone loss of up to 2mm, and a probing depth of ≤3mm. Although the posterior mandible is an area in which the immediate loading of dental implants should be performed with caution, this treatment presented a good success rate in the present study sample.

Resonance frequency analysis of overdenture retainer implants with immediate loading

Objective: To evaluate 16 patients of both sexes with lower overdenture and upper complete dentures, by analysing the resonance frequency of the initial and late stability of implants used to retain the overdenture under immediate loading. Background: Oral rehabilitation treatment with complete dentures using implants has been increasingly more common among the specialists in the oral rehabilitation area. This is an alternative for obtaining retention and stability in treatments involving conventional complete dentures, where two implants are enough to retain the overdenture satisfactorily. Materials and methods: The Osstell (TM) Mentor device was used for the analysis in the initial period (primary stability), 3 and 15 months after the installation of the lower overdenture (secondary stability). The statistical analysis was performed with the repeated measures model (p < 0.01). Results: The implant stability quotients were observed to increase after 15 months of the rehabilitating treatment. Conclusion: The use of overdentures over two lower implants should become the treatment of choice for individuals who have a fully edentulous mandible.

Effect of electromagnetic field on bone regeneration around dental implants after immediate placement in the dog mandible: a pilot study

Background: Accelerating bone healing around dental implants can reduce the long-term period between the insertion of implants and functional rehabilitation. Objective: This in vivo study evaluated the effect of a constant electromagnetic field (CEF) on bone healing around dental implants in dogs. Materials and methods: Eight dental implants were placed immediately after extraction of the first premolar and molar teeth on the mandible of two male dogs and divided into experimental (CEF) and control groups. A CEF at magnetic intensity of 0.8 mT with a pulse width of 25 mu s and frequency of 1.5 MHz was applied on the implants for 20 min per day for 2 weeks. Result and conclusion: After qualitative histological analysis, a small quantity of newly formed bone was observed in the gap between the implant surface and alveolar bone in both groups.

Implant Stability Measurements of Two Immediate Loading Protocols for the Edentulous Mandible: Rigid and Semi-rigid Splinting of the Implants

Aim: Primary and secondary stabilities of immediately loaded mandibular implants restored with fixed prostheses (FP) using rigid or semirigid splinting systems were clinically and radiographically evaluated. Methods: Fifteen edentulous patients were rehabilitated using hybrid FP; each had 5 implants placed between the mental foramens. Two groups were randomly divided: group 1-FP with the conventional rigid bar splinting the implants and group 2-semi-rigid cantilever extension system with titanium bars placed in the 2 distal abutment cylinders. Primary stability was evaluated using resonance frequency analysis after installation of the implant abutments. The measurements were made at 3 times: T0, at baseline; T1, 4 months after implant placement; and T2, 8 months after implant placement. Presence of mobility and inflammation in the implant surrounding regions were checked. Stability data were submitted to statistical analysis for comparison between groups (P, 0.05). Results: Implant survival rate for the implants was of 100% in both groups. No significant differences in the mean implant stability quotient values were found for both groups from baseline and after the 8-month follow-up. Conclusion: The immediate loading of the implants was satisfactory, and both splinting conditions (rigid and semi-rigid) can be successfully used for the restoration of edentulous mandibles. (Implant Dent 2012;21:486-490)

Immediate restoration of nonsubmerged titanium implants with a sandblasted and acid-etched surface: five-year results of a prospective case series study using clinical and radiographic data

The aim of this study was to evaluate the survival and success rates of immediately restored implants with sandblasted, large-grit, acid-etched (SLA) surfaces over a period of 5 years. Twenty patients (mean age, 47.3 years) received a total of 21 SLA wide-neck implants in healed mandibular first molar sites after initial periodontal treatment. To be included in the study, the implants had to demonstrate primary stability with an insertion torque value of 35 Ncm. A provisional restoration was fabricated chairside and placed on the day of surgery. Definitive cemented restorations were inserted 8 weeks after surgery. Community Periodontal Index of Treatment Needs (CPITN) indices and the radiographic distance between the implant shoulder and the first visible bone-implant contact (DIB) were measured and compared over the study period. The initial mean CPITN was 3.24, and decreased over the study period to 1.43. At the postoperative radiographic examination, the mean DIB was 1.41 mm for the 21 implants, indicating that part of the machined neck of the implants was placed slightly below the osseous crest. The mean DIB value increased to 1.99 mm at the 5-year examination. This increase proved to be statistically significant (P < .0001). Between the baseline and 5-year examinations, the mean bone crest level loss was 0.58 mm. Success and survival rates of the 21 implants after 5 years of function were 100%. This 5-year study confirms that immediate restoration of mandibular molar wide-neck implants with good primary stability, as noted by insertion torque values of at least 35 Ncm, is a safe and predictable procedure.

Immediate loading of implants with 3-unit fixed partial dentures: a 12-month clinical study

PURPOSE: The aim of the present clinical trial was to evaluate the 12-month success rate of titanium dental implants placed in the posterior mandible and immediately loaded with 3-unit fixed partial dentures. MATERIALS AND METHODS: Patients with missing mandibular premolars and molars were enrolled in this study. To be included in the study, the implants had to show good primary stability. Implant stability was measured with resonance frequency analysis using the Osstell device (Integration Diagnostics). Implants were included in the study when the stability quotient (ISQ) exceeded 62. Clinical measurements, such as width of keratinized tissue, ISQ, and radiographic assessment of peri-implant bone crest levels, were performed at baseline and at the 12-month follow-up. The comparison between the baseline and the 12-month visits was performed with the Student t test for paired data (statistically significant at a level of alpha = 0.05). RESULTS: Forty implants with a sandblasted, large grit, acid-etched (SLA) surface (Straumann) were placed in 20 patients. At 12 months, only 1 implant had been lost because of an acute infection. The remaining 39 implants were successful, resulting in a 1-year success rate of 97.5%. Neither peri-implant bone levels, measured radiographically, nor implant stability changed significantly from baseline to the 12-month follow-up (P > .05). DISCUSSION: The immediate functional loading of implants placed in this case series study resulted in a satisfactory success rate. CONCLUSION: The findings from this clinical study showed that the placement of SLA transmucosal implants in the mandibular area and their immediate loading with 3-unit fixed partial dentures may be a safe and successful procedure.

Immediate bacterial colonization of titanium implants

Background: The information on bacterial colonization immediately after dental implant insertion is limited. Aims: (1) to assess the early colonization on titanium implants immediately post placement through the first12 post-surgical weeks , (2) to compare the microflora at interproximal subgingival implant and adjacent tooth sites. Material and Methods: Subgingival plaque samples from implant and neighbouring teeth were studied by checkerboard DNA-DNA hybridization before, 30 min. after implant placement , 1 week, 2 weeks, 4 weeks, 8 weeks, and 12 weerks after surgery. Results: Comparing bacterial loads at implant sites between 30 min. after placement with one week data showed that only the levels of V.parvula (p<0.05) differed with higher loads at week 1. Week 12 data demonstrated significantly higher bacterial loads for 15/40 species at tooth sites compared to pre-surgery (p < values varying between 0.05 and 0.01). Between immediately post-surgery and week 12 at implant sites 29/40 species were more commonly found at week 12. Included among these bacteria at implant sites were P.gingivalis (p< 0.05), T.forsythia, (p < 0.01), and T denticola (p<0.001). Immediately post-surgery 5.9% of implants, and 26.2% of teeth and at week 12, 15.0 % of implants, and 39.1% of teeth harbored S.aureus. Comparing tooth and implant sites, significantly higher bacterial loads were found at tooth sites for 27/40 species at the 30 minutes after placement interval. This difference increased to 35/40 species at week 12. Conclusions: The colonization of bacteria occurs within 30 minutes. Colonization patterns differed between implants and tooth surfaces.