Immediate and early loading of oxidized tapered implants in the partially edentulous maxilla: a 1-year prospective clinical, radiographic, and resonance frequency analysis study.
BACKGROUND
The use of immediate/early implant loading protocols offers obvious advantages for the patient. Although well documented in the totally edentulous mandible, information about clinical outcomes from such protocols in the partially edentate maxilla is lacking.


OBJECTIVE
The present study was conducted to clinically and radiographically evaluate a tapered implant design with an oxidized surface for immediate/early loading in the partially edentulous maxilla. The aim was also to correlate implant stability measurements using resonance frequency analysis (RFA) with implant diameter and length, bone quality and quantity, and marginal bone levels and marginal bone loss.


METHODS
A total of 32 patients with a need of implant treatment in their partially edentulous maxilla were included in the study. A total of 53 Replace Select TiUnite implants (Nobel Biocare AB, Göteborg, Sweden) were used in the study; 16 for single tooth replacements in 16 patients and 37 implants for partial bridges in another 16 patients. The single tooth replacements were loaded the same day with a temporary crown, while permanent partial bridges were delivered within 16 days. Intraoral radiographs were taken at surgery and after 1 year for marginal bone measurements. RFA measurements were performed at baseline and after 3, 6, and 12 months.


RESULTS
One implant used for a single tooth replacement failed, giving an overall survival rate of 98.1% after 1 year. On average, 1.1 mm (SD 1.0) bone was lost during 1 year; 1.5 mm (SD 1.0) in single tooth and 0.9 mm (SD 1.0) in partial cases. The implant stability increased with time from 63.3 implant stability quotient (ISQ) (SD 6.1) at baseline to 64.3 (SD 5.3), 65.0 (SD 4.6), and 66.8 (SD 5.6) after 3, 6, and 12 months, respectively. The average change from baseline to 1 year was 3.3 ISQ (SD 5.0) and was statistically significant (p < .05). There was no difference between single and partial cases. Implant stability correlated with bone quantity and quality at implant sites, but not with marginal bone level measurements.


CONCLUSIONS
It is concluded that immediate/early loading can be used in the partially edentulous maxilla with good clinical and radiographic short-term outcomes. Implant stability at placement correlated with bone quantity and quality, and increased with time as measured with RFA, indicating a favorable bone tissue response to the loaded implants. Any correlations between RFA and marginal bone level measurements were not observed in the present study.
Fischer
Kerstin
K
Department of Biomaterials, Institute for Surgical Sciences, Göteborg University, Göteborg, Sweden. kerstin.fischer@swipnet.se
Bäckström
Mats
M
Sennerby
Lars
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016301:Alveolar Bone Loss / Q000209:etiology; D015519:Bone Density / Q000502:physiology; D020099:Coated Materials, Biocompatible / Q000737:chemistry; D003442:Crowns; D000044:Dental Abutments; D015921:Dental Implants; D019250:Dental Implants, Single-Tooth; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003829:Denture, Partial; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery*; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D016348:Osseointegration / Q000502:physiology*; D010087:Oxides; D011446:Prospective Studies; D011859:Radiography; D016896:Treatment Outcome
D020099:Coated Materials, Biocompatible; D015921:Dental Implants; D010087:Oxides