title: Immediate and early loading of Straumann implants with a chemically modified surface (SLActive) in the posterior mandible and maxilla: 1-year results from a prospective multicenter study.
abstract: OBJECTIVE
  Immediate and early loading of implants can simplify treatment and increase patient satisfaction. This 3-year randomized-controlled trial will therefore evaluate survival rates and bone-level changes with immediately and early loaded Straumann implants with the SLActive surface.
  
  
  METHODS
  Partially edentulous patients >or=18 years of age were enrolled. Patients received a temporary restoration (single crown or two to four unit fixed partial denture) out of occlusal contact either immediately (immediate loading) or 28-34 days later (early loading group), with permanent restorations placed 20-23 weeks after surgery. The primary endpoint was change in crestal bone level from baseline (implant placement) to 12 months; the secondary variables were implant survival and success rates.
  
  
  RESULTS
  A total of 383 implants (197 immediate and 186 early) were placed in 266 patients; 41.8% were placed in type III and IV bone. The mean patient age was 46.3+/-12.8 years. Four implants failed in the immediate loading group and six in the early loading group, giving implant survival rates of 98% and 97%, respectively (P=NS). There were no implant failures in type IV bone. The overall mean bone level change from baseline to 12 months was 0.77+/-0.93 mm (0.90+/-0.90 and 0.63+/-0.95 mm in the immediate and early groups, respectively; P<0.001). However, a significant difference in implantation depth between the two groups (P<0.0001) was found. After adjusting for this slight difference in initial surgical placement depth, time to loading no longer had a significant influence on bone-level change. Significant influence was found for: center (P<0.0001), implant length (P<0.05) and implant position (P<0.0001). Bone gain was observed in approximately 16% of implants.
  
  
  CONCLUSIONS
  The results demonstrated that Straumann implants with the SLActive surface are safe and predictable when used in immediate and early loading procedures. Even in poor-quality bone, survival rates were comparable with those from conventional or delayed loading. The mean bone-level change was not deemed to be clinically significant and compared well with the typical bone resorption observed in conventional implant loading.
authors.affiliation: Nova Southeastern University, Fort Lauderdale, FL, USA. jganeles@perio-implant.com
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Ganeles
authors.forename: Axel
authors.initials: A
authors.lastname: Zöllner
authors.forename: Jochen
authors.initials: J
authors.lastname: Jackowski
authors.forename: Christiaan
authors.initials: C
authors.lastname: ten Bruggenkate
authors.forename: Jay
authors.initials: J
authors.lastname: Beagle
authors.forename: Fernando
authors.initials: F
authors.lastname: Guerra
mesh_terms: D000134:Acid Etching, Dental; D000328:Adult; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000209:etiology*; D020099:Coated Materials, Biocompatible; D003442:Crowns; D003722:Dental Alloys; D003758:Dental Implantation, Endosseous / Q000009:adverse effects / Q000379:methods*; D015921:Dental Implants; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003794:Dental Restoration, Temporary; D003799:Dental Stress Analysis; D003831:Denture, Partial, Immediate; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D013499:Surface Properties; D013997:Time Factors; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D020099:Coated Materials, Biocompatible; D003722:Dental Alloys; D015921:Dental Implants; C009495:titanium dioxide; D014025:Titanium