Implant loading protocols for partially edentulous maxillary posterior sites.
OBJECTIVE
To evaluate early and immediate loading of implants in the posterior maxilla and to investigate whether there is a difference in success rates, survival rates, and peri-implant parameters, including marginal bone level changes.


METHODS
A comprehensive systematic review of the literature was conducted. The selection of publications reporting on human clinical studies was based on predetermined inclusion criteria and was agreed upon by two reviewers.


RESULTS
Twelve papers were identified on early loading (two randomized controlled clinical trials [RCTs] and 10 prospective case series studies). Six papers were found on immediate loading (one RCT, four prospective case series, and one retrospective study).


CONCLUSIONS
Under certain circumstances it is possible to successfully load dental implants in the posterior maxilla early or immediately after their placement in selected patients. The success rate appears to be technique sensitive, although no study has directly assessed this. A high degree of primary implant stability (high value of insertion torque) and implant surface characteristics play an important role. It is not possible to draw evidence-based conclusions concerning contraindications, threshold values for implant stability, bone quality and quantity needed, or impact of occlusal loading forces. As for the impact of the surgical technique on implant outcome in different bone densities, no studies prove significant superior results with one technique over another. Well-designed RCTs with a large number of patients are necessary to make early/immediate loading protocols in posterior maxilla evidence based, but ethical and practical considerations may limit the real possibility of such studies in the near future.
Roccuzzo
Mario
M
Department of Oral and Maxillofacial Surgery, University of Torino, Torino, Italy. mroccuzzo@iol.it
Aglietta
Marco
M
Cordaro
Luca
L
D016301:Alveolar Bone Loss / Q000209:etiology; D003442:Crowns; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported / Q000009:adverse effects; D019232:Dental Restoration Failure; D003799:Dental Stress Analysis; D003831:Denture, Partial, Immediate; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000534:rehabilitation* / Q000601:surgery; D008437:Maxilla / Q000601:surgery*; D008963:Molar; D000078202:Systematic Reviews as Topic; D013997:Time Factors; D016474:Weight-Bearing
D015921:Dental Implants