title: Long-term evaluation of immediately loaded implants in the edentulous mandible using fixed bridges and platform shifting.
abstract: BACKGROUND
  The immediate loading concept has been extensively documented in the anterior part of the mandible when six primary stable implants are placed, splinted with a fixed prosthesis.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the long-term success of immediately occlusal loaded implants with a progressive thread design and platform shifting in the edentulous mandible.
  
  
  METHODS
  Seventy-eight implants placed in 13 patients and were connected with their abutments immediately after surgery. The implants were splinted using a fixed temporary restoration having occlusal contacts in the centric and group function in the lateral movements of the mandible (immediate occlusal loading). The patients were advised to use soft/liquid diet for the first 6 to 8 weeks of healing in order to reduce excessive loading in the bone-to-implant interface. Abutment level impressions were taken without removing the abutments in order to fabricate the final prostheses. The final restorations were delivered 4 to 8 weeks after surgery and cemented temporarily in order to evaluate the peri-implant soft tissue condition at the different time intervals after removal of the restoration. Clinical stability and radiological indices were evaluated at the start of loading, at 3-month interval after loading, and then annually.
  
  
  RESULTS
  After a mean loading period of 75.29 (± 38.18) months, no implant was lost (100% success rate). All clinical indices had values in normal levels. The Periotest values demonstrated a continuous reduction, representing high stability. The crestal bone level was relatively stable and only minimal crestal bone loss was observed in some implants.
  
  
  CONCLUSIONS
  Long-term success and stability of the peri-implant tissues around immediately loaded mandibular implants are expected when implants with platform shifting are restored with bridges without abutment removal.
authors.affiliation: School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA; Department of Oral Surgery and Implant Dentistry, Dental School, University of Frankfurt, Frankfurt, Germany.
authors.forename: Georgios E
authors.initials: GE
authors.lastname: Romanos
authors.forename: Kathrin
authors.initials: K
authors.lastname: Gaertner
authors.forename: Georg H
authors.initials: GH
authors.lastname: Nentwig
mesh_terms: D000368:Aged; D000044:Dental Abutments; D019094:Dental Prosthesis, Implant-Supported; D003830:Denture, Partial, Fixed; D005260:Female; D006801:Humans; D057893:Immediate Dental Implant Loading; D007575:Jaw, Edentulous / Q000534:rehabilitation*; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D011862:Radiography, Panoramic; D013499:Surface Properties; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D014025:Titanium
keywords: immediate loading; implant; long-term success; mandible