Impact of immediately loaded implant-supported maxillary full-arch dental prostheses: a systematic review

Abstract

Impact of immediately loaded implant-supported maxillary fullarch dental prostheses: a systematic review The immediate loading of implant-assisted fixed prostheses in edentulous maxillae may achieve favorable success rates with reduced treatment time. An evidence summary of clinical trials is key to recommend loading protocols in these cases. Objectives: To compare immediately loaded, fully implantsupported complete dentures to early and conventional/delayed loading in the edentulous maxillae of adult patients by a systematic review of controlled clinical trials (CCT). Methodology: CCTs reports were identified up to January 17, 2019 from Cochrane Oral Health Group's Trial register, Cochrane Central Register of controlled trials (CENTRAL), MEDLINE (Ovid), BIOSIS, EMBASE, CINAHL, Web of Science, and DARE. Two independent reviewers screened titles/abstracts and confirmed inclusion using full texts. Data were extracted and quality assessed (Cochrane Risk of Bias tool) independently and in duplicate. Study heterogeneity prevented pooling by meta-analysis. Results: Out of 1,052 candidate studies, four CCTs were included. Two trials had patient satisfaction as an outcome: (1) A randomized trial compared immediately and early loaded fixed dentures and found more satisfaction with the first after 12 months; (2) A non-randomized study found better satisfaction with immediate fixed dentures compared to conventional loading after 3 months (no more at 12 months). Regarding implant success and prosthetic complications, three trials did not report significant differences comparing immediate loading to other protocols. Conclusions: This review found weak evidence of differences between immediate load and other loading regimens, regarding patient satisfaction and maintenance events/adversities. The potential of immediate loading for favorable results in edentulous maxillae reinforces the need for well-designed RCTs, for solid clinical guidelines.

Surgical and Prosthetic Outcomes of 967 Implants Under Immediate or Delayed Loading in Full-Arch Rehabilitation: a Retrospective Study With up To 5 Years of Follow-Up

“…The present study found no significant difference between the IL and DL groups regarding implant survival rate, with 99.2% and 97.9%, respectively. The results corroborate with the previously found by other authors but with smaller samples, with survival rates ranging from 93.9% to 100% for immediate loading and between 95.9% and 99% for delayed loading [7,16,17].…”

“…Considering that no significant differences were found in implant and prosthesis survival rates between loading protocols, IL seems to be an effective alternative for full-arch rehabilitation, with predictable results in the long-term. This protocol involves a shorter treatment time, which is essential in achieving patient satisfaction [7]. Nevertheless, since retrospective studies may have some limitations that cannot be entirely overcome, such as limited and less accurate data, further prospective studies are needed to confirm the presented outcomes.…”

“…Nevertheless, to minimize treatment time, a reduced healing period with an onestage surgery has been proposed, whereby abutments and prostheses are inserted at the same procedure of implant placement and demonstrated good clinical outcomes [5,6]. Thereby, with faster functional and aesthetics reestablishment, authors have reported greater patient satisfaction [7].…”

“…Different studies have reported that there are no significant differences for prosthesis success, implant success or marginal bone loss when different implant loading protocols are applied [8][9][10][11]. However, few have evaluated only fixed full-arch rehabilitation and most of these present outcomes involving small samples and/or short follow-up periods [7,12,13].…”

Reabilitação Total Imediata Maxilo-Mandibular Com Prótese Fixa Sobre Implantes Com Conceito All-on-Four: Relato De Caso

“…Sobre a imediaticidade da reabilitação, a literatura mostra que independente do momento em que recebem um tratamento protético reabiltiador fixo, os pacientes ficam mais satisfeitos do que com trabalhos removíveis. A satisfação parece varias também de acordo com o momento do tratamento em que esse quesito é questionado e de acordo com a experência pregressa do paciente com próteses totais (ABDUNABI, et al 2019).…”