No difference between failure rates of early and conventionally loaded implants

Abstract

When individuals are given dental implants, are there different success rates for immediately/ early-loaded implants compared with conventionally loaded implants?Esposito M, Grusovin MG, Willings M, Coulthard P, Worthington HV. Interventions for replacing missing teeth: different times for loading dental implants. Cochrane Database Syst Rev 2007; issue 2Data sources The Cochrane Oral Health Group's Trials Register, Cochrane Central Register of Controlled Trials, Medline and Embase were searched. Handsearching included several dental journals. Authors of all identified trials, an internet discussion group and 55 dental implant manufacturers were contacted to find unpublished randomised controlled trials (RCT). Study selection RCT were selected of root-form osseo-integrated oral implants that had a followup of 6 months-1 year and which compared the same osseo-integrated root-form implants immediately (within 1 week), early (1 week-2 months) and conventionally loaded (after 2 months), giving the following outcome measures: failures, implant failures and marginal bone levels on intra-oral radiographs. Data extraction and synthesis Data were independently extracted, in duplicate, by two review authors. Authors were contacted for details of randomisation and withdrawals and a quality assessment was carried out. The Cochrane Oral Health Group's statistical guidelines were followed. Results Twenty RCT were identified and 11 trials comprising a total of 300 patients were included. Six trials compared immediate versus conventional loading, three early versus conventional loading and two immediate versus early loading. On a patient, rather than per implant basis, there were no statistically significant differences for any of the meta-analyses. Conclusions It is possible to successfully load dental implants immediately or early after their placement in selected patients, but not all clinicians achieve optimal results when loading the implant immediately. A high degree of primary implant stability (high value of insertion torque) seems to be one of the prerequisites for a successful immediate/ early loading procedure. More well-designed RCT are needed. Priority should be given to trials comparing immediately versus early loaded implants to improve patient satisfaction and decrease treatment time and trials should be reported according to the CONSORT guidelines (http://www. consort-statement.org/). CommentaryTo date, there has been limited systematic comparison of the effect of the timing of implant loading on failure rates. Experience and anecdotal opinions favour a conventional approach to implant loading, but currently it seems popular to attempt to complete treatment in the shortest period of time: immediate and early loading have therefore been suggested. The authors of this article deserve credit for investigating such a contentious aspect of implantology.Rigorous searching resulted in 20 RCT being identified, of which 11 were eventually included. Both published and unpublished literature have been looked at in this rev...

Evaluation of Dental Implants Placed in Preserved and Nonpreserved Postextraction Ridges: A 12-Month Postloading Study

“…The ISQ values in the present study are beyond the limit usually set for immediate loading (> 60 to 65), 29 and the survival and success rates together with the MBL confirm that there are no differences between failure rates of early and conventionally loaded implants. 30…”

Immediate provisional restoration of screw‐type implants in the posterior mandible: results after 5 years of clinical function

“…In response to a general call for systematic reviews (Gapski et al 2003; Eliyas & Al‐Khayatt 2008) for follow‐up publications and long‐term data on immediate loading, the data of 40 immediately loaded implants inserted into the posterior mandible recorded over up to 96 months (8 years) were reevaluated.…”

Early loading of surface modified implants in the posterior mandible – 5 year results of an open prospective non‐controlled study

“…Improved understanding of the pre‐conditions for periimplant bone regeneration has lead to more refined concepts of implant loading in that secure primary stability and solid bone quality are considered to form a sound basis for early or immediate loading protocols (Esposito et al. , Eliyas & Al‐Khayatt , Nkenke & Schliephake ). Nevertheless, primary stability that occurs by mechanical interlocking between the implant surface and adjacent bone at the time of implant placement has to be transformed into a biological type of anchorage through osteoconductive bone formation at the interface during bone healing.…”