Immediate occlusal vs nonocclusal loading of implants: A randomized prospective clinical pilot study and patient centered outcome after 36 months

Abstract

Background Immediate provisionalization reduces chair time and improves patient comfort. Purpose To analyze immediate functional loading vs nonfunctional loading with restorations in the posterior mandible for marginal bone defects, implant success/survival, and patient satisfaction. Materials and Methods A randomized controlled clinical trial was designed to assess these parameters based on 20 adult patients who underwent implant surgery, followed by immediate delivery of screw‐retained or cemented single or splinted restorations in full occlusal contact or in infraocclusion (test and control group). A questionnaire with visual analog scales was used to assess patient satisfaction. Results Following 36‐month data were evaluable for 9 patients (21 implants) in the study group (immediate functional loading) and for 10 patients (31 implants) in the control group (immediate nonfunctional loading). One implant in the control group was lost, hence the overall implant survival and success rate was 98.2%. Marginal bone defects were consistent with previous studies and comparable in both groups. Periotest values did not significantly change from baseline and the 12‐month follow‐up (Friedmann test). Patient satisfaction was high and did not involve any significant intergroup differences (Mann‐Whitney U‐test). Conclusions Both types of immediate provisional restorations are viable in selected patients. Larger randomized controlled trials are needed to establish immediate functional loading as a standard treatment for partially edentulous jaws.

Immediate loading of fixed partial prostheses reconstructed using either tapered or straight implants in the posterior area: A randomized clinical trial

“…30 A recent clinical trial similarly found a survival rate of 98.2% at the implant level for implants that were immediately loaded. 31 When comparing these previous results with those present study, the survival rate was lower in the SI group, while that in the TI group was similar. This might have been due to differences in the design of the TI and SI fixtures, and closely related to the primary stability achieved.…”

Does the timing of implant placement and loading influence biological outcomes of implant‐supported multiple‐unit fixed dental prosthesis—A systematic review with meta‐analyses

“…Inter‐rater agreement (kappa score) was 0.63 for the title/abstract and 0.96 for the full‐text screens. A total of 153 studies were categorized as potentially relevant, eight of which could be included upon contacting their authors (Daher et al, 2019 ; Göthberg et al, 2018 ; Oxby et al, 2015 ; Payer et al, 2010 ; Si et al, 2016 ; Siebers et al, 2010 ; Simons et al, 2015 ; Vogl et al, 2019 ). Fourteen studies were finally included: Six RCTs, five cohort (four observational cohort and one case–control) studies, and three case series (two prospective and one retrospective).…”

“…Regarding RCT studies, 3 of them (Daher et al, 2019 ; Fung et al, 2011 ; Van Nimwegen et al, 2015 ) were evaluated as having some concerns in terms of risk bias. Two were rated with high risk of bias (Romanos et al, 2016 ; Vogl et al, 2019 ), and only one was rated with low risk of bias (Göthberg et al, 2018 ).…”

“…Some studies indicated that implant placement had taken place >3 months (Göthberg et al, 2018;Oxby et al, 2015;Van Nimwegen et al, 2015), >4 months (Fung et al, 2011), or >3 to 6 months (Spies et al, 2015) after tooth extraction. Others were categorized as delayed placement based on statements that the implants had been inserted in healed (An et al, 2019;Degidi et al, 2011;Simons et al, 2015;Vogl et al, 2019) or edentulous (Romanos et al, 2016) ridge areas. As most placement and loading protocols were covered by few or no studies, only one direct comparison was performed (DPIL versus DPDL).…”

Marginal bone level change during sequential loading periods of partial edentulous rehabilitation using immediately loaded self-tapping implants: a 6.5-year retrospective study

“…Higher primary stability, nonocclusally loaded temporary restorations during a 3-month healing, splinted implants, and biocompatible prosthetic materials may reduce the risk of implant failure. 25 26 27 28 For partial prostheses, implants were splinted to support a preferable force distribution to the bone-implant interface under functional occlusion. The lateral forces were reduced by restricting working side contacts to the canines to retain implant micromotions.…”