Immediate loading of single SLA implants: drilling vs. osteotomes for the preparation of the implant site.
OBJECTIVE
To evaluate whether or not preparation of the implant site with osteotomes instead of drilling may improve peri-implant bone density and/or osseointegration, and whether or not this further improves the predictability of immediate loading of SLA implants.


METHODS
The second, third, and fourth premolars were extracted in both sides of the mandible in six dogs, and after at least 3 months four SLA implants were inserted into each side of the jaw. In three animals, the implant sites were prepared by means of osteotomes, while standard stepwise drilling was used in the remaining animals. In each side of the jaw, two non-adjacent implants were restored with single crowns 4 days after installation, while the remaining two implants were left without crowns to serve as non-loaded controls. After 2, 4, or 12 weeks of loading, specimens including the implants and surrounding tissues were obtained and processed for histologic analysis of undecalcified sections.


RESULTS
All implants placed with osteotomes were lost (five before delivery of the crowns and the rest during the first week after loading). None of the conventionally inserted implants, however, was lost, and histomorphometrical analysis revealed similar soft- and hard peri-implant tissue characteristics at immediately loaded and non-loaded implants at all observation times. Average bone-to-implant contact was 59-72% at immediately loaded implants vs. 60-63% at non-loaded ones.


CONCLUSIONS
Preparation of the implant site by means of osteotomes had a deleterious effect on osseointegration, while immediate loading of single, free-standing, SLA implants following a conventional surgical protocol did not jeopardize their osseointegration.
Stavropoulos
Andreas
A
Department of Periodontology and Oral Gerontology, Royal Dental College, University of Aarhus, Aarhus, Denmark. stavropoulos@odont.au.dk
Nyengaard
Jens R
JR
Lang
Niklaus P
NP
Karring
Thorkild
T
D000818:Animals; D003442:Crowns; D003755:Dental High-Speed Technique; D003758:Dental Implantation, Endosseous / Q000295:instrumentation / Q000379:methods*; D019250:Dental Implants, Single-Tooth; D017268:Dental Prosthesis Retention; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003799:Dental Stress Analysis; D003831:Denture, Partial, Immediate; D004285:Dogs; D005260:Female; D016348:Osseointegration; D010027:Osteotomy / Q000009:adverse effects*; D013997:Time Factors; D019415:Torque; D014732:Vibration