title: Immediate versus early loading of two implants placed with a flapless technique supporting mandibular bar-retained overdentures: a single-blinded, randomised controlled clinical trial.
abstract: OBJECTIVE
  To evaluate the efficacy of immediate loading versus early loading at 6 weeks of bar-retained mandibular overdentures supported by two implants placed with a flapless technique.
  
  
  METHODS
  Sixty patients were randomised: 30 to the immediately loaded group and 30 to the early loaded group. To be immediately loaded, implants had to be inserted with a minimum torque > 48 Ncm. Outcome measures were prosthesis and implant failures, biological and biomechanical complications, patient satisfaction, and Implant Stability Quotient (ISQ) assessed with a resonance frequency analysis instrument.
  
  
  RESULTS
  Sixty implants were placed in each group. Flaps had to be raised in nine patients to check drill direction or to better visualise the area after multiple teeth extraction. Two implants in two patients did not reach the planned insertion torque and were immediately replaced by larger diameters ones. After 1 year no drop out occurred and two early loaded implants failed in two patients. There were no statistically significant differences between groups for prosthesis failures, implant losses, complications, and mean ISQ values; however, patients in the immediately loaded group were significantly more satisfied than those loaded early. When comparing mean ISQ values taken 6 weeks after placement with 1-year data within each group, values decreased significantly.
  
  
  CONCLUSIONS
  Mandibular overdentures can be successfully loaded the same day of implant placement with a minimally invasive surgery, increasing patient satisfaction while decreasing treatment time and patient discomfort. No apparent advantages were seen when loading the overdentures at 6 weeks.
authors.affiliation: Department of Dentistry and Maxillo-Facial Surgery, University of Modena and Reggio Emilia, Pavia, Italy. gio_cannizzaro@libero.it
authors.forename: Gioacchino
authors.initials: G
authors.lastname: Cannizzaro
authors.forename: Michele
authors.initials: M
authors.lastname: Leone
authors.forename: Marco
authors.initials: M
authors.lastname: Esposito
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D000044:Dental Abutments; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003779:Denture Design; D003781:Denture Retention / Q000295:instrumentation; D003826:Denture, Complete, Lower; D003828:Denture, Overlay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D019226:Oral Ulcer / Q000209:etiology; D016348:Osseointegration / Q000502:physiology; D017060:Patient Satisfaction; D011183:Postoperative Complications; D016037:Single-Blind Method; D019415:Torque; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants