A 5-year report from a multicentre randomised clinical trial: immediate non-occlusal versus early loading of dental implants in partially edentulous patients.
OBJECTIVE
To compare peri-implant bone and soft-tissue levels of immediately non-occlusally loaded versus non-submerged early loaded implants in partially edentulous patients 5 years after implant placement.


METHODS
Fifty-two patients were randomised in five Italian private practices: 25 in the immediately loaded group and 27 in the early loaded group. To be immediately loaded, single implants had to be inserted with a torque of > 30 Ncm, and splinted implants with a torque of > 20 Ncm. Immediately loaded implants were provided with non-occluding temporary restorations within 48 hours. After 2 months, the provisional restorations were put in full occlusion. Implants were early loaded after 2 months. Final restorations were provided 8 months after implant placement. Outcome measures were prosthesis and implant failures as well as biological and prosthetic complications recorded by non-blinded assessors. Blinded assessors evaluated peri-implant bone and soft-tissue levels.


RESULTS
Fifty-two implants were immediately loaded and 52 early loaded. One patient of the early loaded group dropped out after the 1-year recall. One single immediately loaded implant failed 2 months after placement. Only one complication (iatrogenic peri-implantitis) occurred in one patient of the early loading group. Both groups gradually lost peri-implant bone in a highly statistically significant way at 2, 8 and 14 months and at 4 and 5 years. After 5 years, patients of both groups had lost an average of 1.2 mm of peri-implant marginal bone. There were no statistically significant differences in peri-implant bone and soft-tissue level changes between the 2 groups. At 5 years, there was a statistically significant recession (0.2 mm) of the vestibular soft tissues from baseline (delivery of the final restorations 8 months after implant placement) only for immediately loaded implants.


CONCLUSIONS
In well maintained patients, complications are uncommon and healthy and stable periimplant tissues can be maintained for 5 years around immediately and early loaded implants.
Capelli
Matteo
M
Section of Implantology and Oral Rehabilitation, Dental Clinic, IRCCS Galeazzi Orthopaedic Institute, Department of Health Technologies, Università degli Studi di Milano, Milan, Italy.
Esposito
Marco
M
Zuffetti
Francesco
F
Galli
Fabio
F
Del Fabbro
Massimo
M
Testroi
Tiziano
T
D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000209:etiology; D015519:Bone Density / Q000502:physiology; D000044:Dental Abutments; D003758:Dental Implantation, Endosseous / Q000295:instrumentation / Q000379:methods; D015921:Dental Implants; D019250:Dental Implants, Single-Tooth; D003766:Dental Occlusion; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003794:Dental Restoration, Temporary; D005260:Female; D005500:Follow-Up Studies; D005889:Gingival Recession / Q000209:etiology; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000534:rehabilitation / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000209:etiology; D013997:Time Factors; D019415:Torque; D016896:Treatment Outcome
D015921:Dental Implants