Five-year results from a randomized, controlled trial on early and delayed loading of implants supporting full-arch prosthesis in the edentulous maxilla.
OBJECTIVE
The overall aim was to compare the clinical outcomes of early and delayed implant loading in the totally edentulous maxilla during 5 years of function.


METHODS
Twenty-four patients with edentulous maxillae were randomized in two groups and subjected to early (test, n=16) or delayed (control, n=8) loading. A total of 142 implants were placed and 139 implants (Straumann AG) were loaded with full-arch bridges and followed for 5 years.


RESULTS
All patients received and maintained a fixed bridge throughout the study period. Five (5.3%) test implants in three patients and two (4.3%) control implants in two patients were lost during the 5 years (NS). There were no differences in implant stability as measured with resonance frequency analysis at 5 years. More bone loss occurred at test than at control implants, -0.8 mm (SD 1.2) vs. -0.3 mm (SD 1.1), respectively. However, test implants showed a more coronal marginal bone level than control implants after 5 years, 2.9 mm (SD 1.1) vs. 3.7 mm (SD 1.2) from the implant shoulder, respectively. No control implants and four (4.4%) test implants in three (18.8%) patients showed >3 mm bone loss after 5 years. Two of the latter implants in one patient also showed increased probing depths, bleeding at probing and plaque accumulation. Tooth fracture was the most common prosthetic complication. The use of lingual gold onlay effectively reduced the number of resin-related complications as opposed to a resilient mouth guard.


CONCLUSIONS
The present randomized controlled trial showed no important differences between early and delayed loading of implants in the edentulous maxilla after 5 years of function. A favourable long-term marginal bone response to the sandblasted large-grit acid-etched (SLA) surface was observed. Technical complications were mainly resin-related which could be avoided by the use of a lingual gold onlay. It is concluded that early loading of SLA-surface implants for support of full-arch bridges represents a viable therapy for the totally edentulous maxilla.
Fischer
Kerstin
K
Department of Biomaterials, Institute for Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden. kerstin.fischer@swipnet.se
Stenberg
Torsten
T
Hedin
Måns
M
Sennerby
Lars
L
D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000209:etiology; D003758:Dental Implantation, Endosseous / Q000009:adverse effects / Q000379:methods*; D015921:Dental Implants; D017268:Dental Prosthesis Retention; D019094:Dental Prosthesis, Implant-Supported / Q000009:adverse effects; D019232:Dental Restoration Failure; D003799:Dental Stress Analysis; D003827:Denture, Complete, Upper; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007575:Jaw, Edentulous / Q000000981:diagnostic imaging / Q000534:rehabilitation*; D015993:Life Tables; D008297:Male; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D018709:Statistics, Nonparametric; D013499:Surface Properties; D013997:Time Factors; D016896:Treatment Outcome; D014732:Vibration; D016474:Weight-Bearing
D015921:Dental Implants