title: Early loading after 21 days of healing of nonsubmerged titanium implants with a chemically modified sandblasted and acid-etched surface: two-year results of a prospective two-center study.
abstract: OBJECTIVE
  The aim of this two-center study was to evaluate screw-type titanium implants with a chemically modified, sandblasted and acid-etched surface when placed in the posterior maxilla or mandible, and loaded 21 days after placement.
  
  
  METHODS
  All 56 patients met strict inclusion criteria and provided informed consent. Each patient displayed either a single-tooth gap, an extended edentulous space, or a distal extension situation in the posterior mandible or maxilla. Eighty-nine dental implants (SLActive, Institut Straumann AG, Basel, Switzerland) were inserted according to an established nonsubmerged protocol and underwent undisturbed healing for a period of 21 days. Where appropriate, the implants were loaded after 21 days of healing with provisional restorations in full occlusion. Definitive metal ceramic restorations were fabricated and positioned on each implant after 6 months of healing. Clinical measurements regarding soft tissue parameters and radiographs were obtained at different time points up to 24 months after implant placement.
  
  
  RESULTS
  Of the 89 inserted implants, two (2.2%) implants failed to integrate and were removed during healing, and two (2.2%) additional implants required a prolonged healing time. A total of 85 (95.6%) implants were therefore loaded without incident after 21 days of healing. No additional implant was lost throughout the study period, whereas one implant was lost to follow-up and therefore left unaccounted for further analysis. The remaining 86 implants all exhibited favorable radiographic and clinical findings. Based on strict success criteria, these implants were considered successfully integrated 2 years after insertion, resulting in a 2-year success rate of 97.7%.
  
  
  CONCLUSIONS
  The results of this prospective two-center study demonstrate that titanium implants with a modified SLA surface can predictably achieve successful tissue integration when loaded in full occlusion 21 days after placement. Integration could be maintained without incident for at least 2 years of follow-up.
authors.affiliation: Department of Diagnostic Sciences, Prosthodontics and Restorative Dentistry, School of Dentistry, University of Louisville, Louisville, KY, USA.
authors.forename: Dean
authors.initials: D
authors.lastname: Morton
authors.forename: Michael M
authors.initials: MM
authors.lastname: Bornstein
authors.forename: Julia-Gabriela
authors.initials: JG
authors.lastname: Wittneben
authors.forename: William C
authors.initials: WC
authors.lastname: Martin
authors.forename: James D
authors.initials: JD
authors.lastname: Ruskin
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Hart
authors.forename: Daniel
authors.initials: D
authors.lastname: Buser
mesh_terms: D000134:Acid Etching, Dental / Q000379:methods*; D000180:Acrylic Resins / Q000737:chemistry; D000044:Dental Abutments; D045662:Dental Etching / Q000379:methods*; D003758:Dental Implantation, Endosseous / Q000379:methods; D015921:Dental Implants; D003764:Dental Materials / Q000737:chemistry; D003774:Dental Plaque Index; D003776:Dental Porcelain / Q000737:chemistry; D017267:Dental Prosthesis Design; D019232:Dental Restoration Failure; D003794:Dental Restoration, Temporary; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000534:rehabilitation / Q000601:surgery; D008334:Mandible / Q000601:surgery; D008437:Maxilla / Q000601:surgery; D016876:Metal Ceramic Alloys / Q000737:chemistry; D016348:Osseointegration / Q000502:physiology; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification; D011446:Prospective Studies; D016300:Radiography, Bitewing; D014025:Titanium / Q000737:chemistry; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
chemical_list: D000180:Acrylic Resins; D015921:Dental Implants; D003764:Dental Materials; D016876:Metal Ceramic Alloys; D003776:Dental Porcelain; D014025:Titanium