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

Abstract

Background: 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. Purpose: 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. Material and Methods: 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, χ 2 , Wilcoxon paired, and McNemar tests. Results: 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. Conclusions: 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.

Patient-Centered Treatment Outcomes with Full-Arch PEEK Rehabilitation Supported on Four Immediate or Conventionally Loaded Implants. A Randomized Clinical Trial

“…Current evidence comes from CL implants in most studies, except for those studies focused on assessing the all-on-four concept in which all implants are immediately loaded with a provisional fixed prosthesis and then data from the CL group is missing [ 15 , 16 ]. In agreement with our results, some authors concluded that IL tends to improve the OHRQoL and satisfaction of mandibular overdenture wearers, faster and sooner than that observed with CL groups one year after implant treatments [ 29 , 43 , 45 ].…”

“…In agreement with other studies [ 29 , 41 , 42 ] using the same assessment tools, the postoperative satisfaction and quality of life scores reported in the present study are higher than those observed among patients treated with two-implant retained overdentures. Specifically, the major improvements were observed among pain , functional limitation , and physical disability OHIP-dimensions ( Table 8 ), as found in other studies [ 29 , 43 ]. In contrast, Kok failed to find significant differences between hybrids and overdentures regarding satisfaction and OHQoL in a randomized clinical trial [ 44 ].…”

Immediate versus conventional loading (IL vs. CL) influence on implant marginal bone loss (MBL): an overview

“…No statistically significant differences were found in MBL between groups after 1-year follow-up (P>0.05). The mean MBL for the conventional and IL group was similar, about −0.05 mm (17). The results of this study agreed with some systematic reviews.…”

Clinical Versatility of the Facility-Equator Implant System as Mandibular Overdenture Retainers

“…However, IL patients require more time to acquire similar chewing performance than CL patients. The survival rates and number of prosthetic intercurrences were also similar in both groups: 90% in the CL group (2 losses) and 85% in the IL group (3 losses); 33 prosthetic events occurred in the CL group and 23 in the IL group, mainly Equator dislodgements, followed by replacement of the prosthetic abutment [24].…”