Does loading time affect implant survival? A meta-analysis of 1,266 implants.
BACKGROUND
Considerable controversy exists as to whether immediate or early implant loading is associated with a higher failure rate compared to conventional loading. Numerous trials conducted have yielded inconsistent results, partly due to low statistical power. Thus, we sought to determine whether combining results from all published trials would provide a better estimate of the impact of implant loading time on survival.


METHODS
We carried out a meta-analysis of all previously published prospective trials comparing conventional with early or immediate implant loading. The outcome of interest was implant failure rate. The Q statistics test was used to assess the presence of heterogeneity. We identified relevant studies through a search of the MEDLINE database and the Cochrane Registry of Controlled Trials.


RESULTS
We found 13 prospective trials (1,266 implants) in which early or immediate implant loading was compared to conventional loading. Overall there was no difference in implant failure rate between loading techniques (odds ratio [OR] 0.91; 95% CI: 0.41 to 2.03; P=0.41). Implant failure occurred slightly, although not statistically significant, less often with early implant loading (OR 0.52; 95% CI: 0.22 to 1.24; P=0.07). Immediate implant loading was associated with slightly, although not statistically significant, worse outcomes (OR 1.26; 95% CI: 0.38 to 4.13; P=0.35). Pooling of randomized controlled trials (RCTs) confirmed these results.


CONCLUSIONS
In a meta-analysis of 13 prospective trials, early implant loading was not associated with worse outcomes compared to conventional loading. Further evaluations in adequately powered large prospective trials are needed to confirm these findings.
Ioannidou
Effie
E
Department of Periodontology, University of Connecticut Health Center, Farmington, CT 06030-1710, USA.
Doufexi
Aikaterini
A
D018849:Controlled Clinical Trials as Topic; D003758:Dental Implantation, Endosseous / Q000379:methods*; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003799:Dental Stress Analysis; D006801:Humans; D013997:Time Factors; D016474:Weight-Bearing