Early loading of splinted implants in posterior mandible: Three‐year results of a prospective multicenter study

Abstract

Objective: To evaluate the clinical outcomes of an early loading protocol of splinted implants with a fluoride-modified nanostructure surface and a tapered apex design for the therapy of posterior partial edentulism of mandible. Materials and Methods:One hundred and seven implants were placed in the mandible of 45 subjects at three centres in China. A minimum of two and a maximum of three implants were placed in an edentulous region using a one-stage protocol.Each subject received a screw-retained, splinted and fixed permanent prosthesis 6-8 weeks after surgery. Marginal bone level (MBL) change, implant survival and soft tissue health were assessed at 6, 12, 24 and 36 months after loading. A total of 92 implants from 40 subjects were recalled and investigated in this clinical trial. Results: After three-year loading, the survival rate of implant was 100%. On a subject level, there was a mean (±SD) marginal bone gain of 0.23 ± 0.48 mm at 36-month recall and the change in MBL was statistically significant (p = .00061) compared with time of loading. On an implant level, the change in MBL was statistically significant (p = .03914, p = .01494, p = .00000) at 12, 24 and 36 months of loading compared with time of loading. Conclusion:Three-year data indicate that early loading protocol of splinted implants with a fluoride-modified nanostructure surface and a tapered apex design is feasible and safe for the therapy of partial edentulism in posterior mandible, which may contribute to bone gain when the suitable occlusal load and oral hygiene maintenance are kept. K E Y W O R D Sdental implants, early loading, marginal bone level, one-stage surgery, splinted restorations

Short communication: Cemented implant reconstructions are associated with less marginal bone loss than screw‐retained reconstructions at 3 and 5 years of loading

“…Single, partial and complete prosthetic constructions were included. Radiographic data from 14 prospective, multicentre clinical trials with a 3‐ to 5‐year follow‐up were retrieved from a database (Dentsply Sirona Implants, Mölndal, Sweden) (Ban et al., 2015; Cooper et al., 2014, 2019; Galindo‐Moreno et al., 2017; Han et al., 2018; Liu et al., 2019; Sanz et al., 2014; Schliephake et al., 2012; Stanford et al., 2016; Temmerman et al., 2019; Thoma et al., 2018; Toljanic et al., 2016; Xie et al., 2015; Zadeh et al., 2018). The aforementioned studies were approved by the Local Ethical Committee at each study centre (Supplement).…”

The Bone Buttress Theory: The Effect of the Mechanical Loading of Bone on the Osseointegration of Dental Implants

“…According to the authors, the response of the cortical bone to the applied stress consisted of the rearrangement of its structure and an increase in its mass [ 13 ]. On the other hand, Liu et al placed 107 implants in 45 patients and observed a statistically significant bone gain 12, 24 and 36 months after loading [ 50 ].…”

La eficacia clínica a largo plazo de los implantes con conexión interna y superficie arenada y grabada

“…El 64,1% de los implantes fué insertado en el sector posterior y el 35,9% en el sector anterior. El sector posterior representa el área ideal para valorar el éxito biomecánico de los implantes porque son sometidos a mayores fuerzas masticatorias y las cargas oclusales y parafuncionales se concentran más en esta región [33][34] .…”

“…Los protocolos de carga precoz se han desarrollado, fundamentalmente, porque ha mejorado el conocimiento de la oseointegración que ha ayudado a desarrollar nuevos diseños de los implantes modernos. Las espiras cervicales y la superficie arenada y/o grabada) han logrado incrementar un buen contacto hueso-implante y una rápida oseointegración 9,[17][18][19] . También se han desarrollado nuevos materiales y aditamentos protésicos así como mayores niveles de precisión y ajuste que han logrado una mejor unión pilar-implante, y han reducido también el tiempo de espera de la carga funcional convencional a protocolos de carga precoz con unos resultados funcionales y estéticos muy favorables [43][44] .…”

“…Sin embargo, la investigación experimental y clínica ha desarrollado diferentes tipos de carga funcional como la carga precoz. En este sentido, la carga precoz puede ser realizada mediante una selección cuidadosa de cada caso con buena calidad y cantidad de hueso y unas técnicas quirúrgica y prostodóncica adecuadas que asegure una respuesta favorable a corto y largo plazo de los pacientes tratados [17][18] .…”