Immediate occlusal loading of Brånemark TiUnite implants placed predominantly in soft bone: 1-year results of a prospective clinical study.
BACKGROUND
The original Brånemark protocol for dental implant treatment was based on submerged healing prior to loading. However, immediate loading has been reported possible with high success rates for various indications, provided that good bone quality and quantity are present. In many of these studies, machined-surface implants have been used. Recently, a new surface texture has been developed, based on an oxidation processing, that aims to enhance the early bone response (Brånemark System Mk IV TiUnite , Nobel Biocare AB, Gothenburg, Sweden). It has been documented that this surface texture may help to better maintain primary implant stability during the early healing period and that secondary implant stability can be reached earlier compared with results when using a machined surface. Such a positive influence on implant stability might be an advantage when applying an immediate-loading protocol, especially in soft bone regions where a tendency toward reduced success rates has been reported.


OBJECTIVE
The aim of this report was to present the short-term success rates of TiUnite-surfaced immediate occlusally loaded Brånemark System Mk IV implants placed in various regions of the jaws.


METHODS
Thirty-eight patients received a total of 51 prosthetic reconstructions, all of which were connected on the day the implants were inserted. Of these, 20 were single-tooth restorations, 30 were fixed partial dentures, and 1 was a complete fixed lower jaw restoration. These prostheses were supported by 102 Brånemark System Mk IV TiUnite implants (38 maxillary and 64 mandibular), the majority of which were placed in posterior regions (88%) and mainly in soft bone (76%). Cutting resistance measurements were performed during implant insertion, and resonance frequency measurements were conducted during the course of the study. Furthermore, radiographic examinations were performed in connection with the delivery of the prostheses and at the 1-, 6-, and 12-month follow-up visits. This article reports on the results after 1 year of loading.


RESULTS
Three maxillary implants were removed, although stable, in one patient at the 8-week follow-up because of postoperative infection in the adjacent area of guided bone regeneration (GBR). This resulted in a cumulative success rate of the implants of 97.1% after 1 year of prosthetic loading. The mean marginal bone resorption after 1 year of loading was 1.2 +/- 0.9 mm (SD).


CONCLUSIONS
The applied immediate loading protocol in combination with a slightly tapered implant and a modified implant surface texture was shown to be a successful treatment alternative even in regions exhibiting soft bone.
Glauser
Roland
R
Department for Fixed and Removable Prosthodontics, University of Zürich, Zürich, Switzerland. glauser@zzmk.unizh.ch
Lundgren
Anna Karin
AK
Gottlow
Jan
J
Sennerby
Lars
L
Portmann
Michael
M
Ruhstaller
Petra
P
Hämmerle
Christoph H F
CH
D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000209:etiology / Q000534:rehabilitation / Q000601:surgery; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants / Q000009:adverse effects; D003775:Dental Polishing; D017267:Dental Prosthesis Design; D017268:Dental Prosthesis Retention; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003831:Denture, Partial, Immediate; D005260:Female; D016557:Guided Tissue Regeneration, Periodontal; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D010087:Oxides; D011446:Prospective Studies; D011859:Radiography; D013165:Splints; D013499:Surface Properties
D015921:Dental Implants; D010087:Oxides