Immediate functional loading in the maxilla using implants with platform switching: five-year results.
OBJECTIVE
Immediate loading in the maxilla is not a routinely recommended treatment concept; however, some clinical series have shown a high survival rate for nonfunctionally loaded implants. The purpose of this study was to demonstrate the prognosis for immediately loaded implants with a progressive thread design and platform switching placed in the maxilla with or without simultaneous augmentations using autogenous bone.


METHODS
Ninety implants were placed (six in each maxillary arch) in 15 patients. Immediately after surgery, the implants were loaded with a provisional acrylic resin prosthesis (immediate occlusal loading). Splinting of the implants with the provisional remained for 6 to 8 weeks of healing. In patients with augmented sites, a 3-month period of provisionalization was necessary to ensure implant stability; a soft/liquid diet was recommended for this intermediate transitional period. Definitive fixed restorations were then fabricated and delivered. Clinical and radiologic examinations of the implants were performed at various times.


RESULTS
After a mean loading period of 42.4 (+/- 19.15) months, only three failures were reported. This represented a survival rate of 96.66%. No complications, including inflammation or bone loss, were reported during the study period.


CONCLUSIONS
Based on these results, the immediate loading protocol in the maxilla can be used successfully when implant primary stability, cross-arch stabilization, and a soft diet for the initial stages of healing are considered.
Romanos
George E
GE
Department of Oral Surgery and Implantology, Dental School (Carolinum), Frankfurt, Germany. grperio@gmail.com
Nentwig
George Hubertus
GH
D000540:Alveolar Ridge Augmentation / Q000379:methods; D016025:Bone Transplantation; D000044:Dental Abutments; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D003833:Denture, Partial, Temporary; D005260:Female; D006801:Humans; D007575:Jaw, Edentulous / Q000534:rehabilitation; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D016348:Osseointegration; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome; D016474:Weight-Bearing
D015921:Dental Implants