Immediate occlusal loading of implants in the partially edentate mandible: a prospective 1-year radiographic and 4-year clinical study.
OBJECTIVE
The purpose of the present prospective clinical study was to evaluate the radiographic and clinical outcome of immediately loaded implants in the partial edentulous mandible over a 4-year follow-up period using a modified surgical protocol, primary implant stability criteria, and splinting for inclusion.


METHODS
Patients in need of implant treatment in the partial edentate mandible were consecutively included in the study. The implant sites were underprepared to obtain maximal stability. Inclusion criteria for the study were torque of a least 30 Ncm before final seating of the implant and an ISQ greater than 60. A provisional fixed partial denture was delivered within 24 hours and a definitive fixed partial denture within 3 months. The patients were monitored with clinical and radiographic follow-up examinations for up to 4 years. Stability of the implants was measured with resonance frequency analysis at placement and after 6 months.


RESULTS
Ninety-six patients were evaluated, and 77 patients who met the inclusion criteria were included. A total of 111 fixed partial dentures supported by 257 Brånemark System implants (77 turned and 180 TiUnite implants) were delivered. Four (1.6%) of the 257 implants did not osseointegrate, giving an overall survival rate of 98.4% after 4 years. Three turned (3.9%) implants and 1 oxidized implant (0.6%) failed after 4 to 13 months. The average marginal bone resorption was 0.7 mm (SD 0.78) during the first year in function. Turned implants showed an average bone loss of 0.5 mm (SD 0.8) and oxidized implants an average of 0.7 mm (SD 0.8). Resonance frequency analysis showed a mean implant stability quotient of 72.2 (SD 7.5) at placement and 72.5 (SD 5.7) after 6 months of loading.


CONCLUSIONS
It is concluded that immediate loading of implants with firm primary stability in partially edentulous areas of the mandible appears to be a viable procedure with predictable outcome.
Department of Biomaterials, Institute for Surgical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden. po@holmgatan.se
Pär-Olov
PO
Ostman
Mats
M
Hellman
Lars
L
Sennerby
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016301:Alveolar Bone Loss / Q000209:etiology; D003758:Dental Implantation, Endosseous / Q000009:adverse effects / Q000379:methods; D015921:Dental Implants / Q000009:adverse effects; D017268:Dental Prosthesis Retention; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003799:Dental Stress Analysis; D003830:Denture, Partial, Fixed; D003831:Denture, Partial, Immediate; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000534:rehabilitation*; D008297:Male; D008334:Mandible / Q000601:surgery; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014732:Vibration
D015921:Dental Implants