A retrospective analysis of early and delayed loading of full-arch mandibular prostheses using three different implant systems: clinical results with up to 5 years of loading.
BACKGROUND
Early loading of implant-supported prostheses in the edentulous mandible is widely accepted, but do the clinical results replicate those of delayed loading?


OBJECTIVE
The aim of this study was to evaluate clinical outcome and patient satisfaction with early or delayed loading in patients treated with fixed prostheses, using three different implant systems.


METHODS
One hundred and nine consecutively treated patients received 490 implants supporting fixed prostheses; 82 patients with Brånemark System implants (Nobel Biocare AB, Göteborg, Sweden), 16 with Astra Tech implants (Astra Tech AB Dental Implant system, Mölndal, Sweden), and 11 with ITI MonoType implants (ITI Dental Implant System, Institute Straumann AG, Waldenburg, Switzerland). Prostheses were placed within 2 to 3 weeks in 55 patients; 54 patients underwent a two-stage procedure. Data were collected from patient records and radiographs; 83 patients attended a clinical examination and received a questionnaire.


RESULTS
All patients had fixed prostheses at follow-up with a mean observation time of 3.5 years. Cumulative survival rates (CSRs) were 92.5% of prostheses and 94.4% of implants for early loading, and 98.0 and 97.9% for delayed loading. The mean radiographic bone loss after the first year was small, and at 5 years less than 0.2 mm for both groups. With early loading, significantly more prostheses (p < .05) needed adjustment or replacement.


CONCLUSIONS
Statistically significantly more prostheses needed adjustment or replacement in the early group. The present study suggested lower CSRs for prostheses and implants in the early loading group after 5 years; the difference was not statistically significant. Larger study samples are needed to verify statistically small differences between treatment techniques.
Eliasson
Alf
A
Department of Prosthetic Dentistry, Postgraduate Dental Education Center, Orebro, Sweden. alf.eliasson@orebroll.se
Blomqvist
Fredrik
F
Wennerberg
Ann
A
Johansson
Anders
A
D000368:Aged; D000369:Aged, 80 and over; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging; D000044:Dental Abutments; D003758:Dental Implantation, Endosseous / Q000379:methods; D015921:Dental Implants; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D019554:Dental Restoration Wear; D003819:Denture Bases; D003779:Denture Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007575:Jaw, Edentulous / Q000534:rehabilitation / Q000601:surgery*; D008297:Male; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D019558:Occlusal Adjustment; D017060:Patient Satisfaction; D011859:Radiography; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D014093:Tooth, Artificial; D016896:Treatment Outcome
D015921:Dental Implants