title: Early loading of titanium dental implants with an intra-operatively conditioned hydrophilic implant surface after 21 days of healing.
abstract: OBJECTIVE
  The aim of the present observational medical device performance study was to test whether implants with an intra-operatively conditioned hydrophilic surface can be safely reconstructed when applying an early loading protocol after 21 days in partially edentulous posterior mandibles.
  
  
  METHODS
  Partially edentulous patients with missing teeth in the posterior mandible were recruited. Immediately after implant placement, the implant position was indexed using a pickup impression technique. ISQ values were measured after 21 days of healing. When ISQ values were ≥70, the implants were directly restored with provisional reconstructions in occlusal contact allowing an early loading protocol. ISQ values were repeated again at 1, 3, and 6 months postloading. Clinical parameters (mPLI, mSBI, PPD, DIM, and CAL) were assessed. Standardized periapical radiographs were obtained after surgery, at implant loading and 3 and 6 months later. Changes over time were analyzed for statistical significance using the nonparametric method by Brunner & Langer (SAS Proc Mixed).
  
  
  RESULTS
  Fifteen partially edentulous patients with healed sites in the posterior mandible received 20 implants. All implants healed uneventfully. At 21 days, all implants achieved an ISQ value of ≥70 (mean of 3 measurements) and were reconstructed at this time point with provisionals. ISQ values showed a gradual increase from baseline to 3 and 6 months postloading. The assessment of clinical parameters revealed stable tissue integration. The evaluation of the radiographs showed that 3 and 6 months after loading the median mesial and distal marginal bone levels had stabilized at the border between the rough surface and the 1-mm machined implant collar.
  
  
  CONCLUSIONS
  Functional occlusal loading of implants with a hydrophilic, moderately rough endosseal surface 3 weeks after placement appears to be a safe and predictable treatment option in healed sites in the posterior mandible without need of bone augmentation procedures.
authors.affiliation: Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.|Division of Fixed Prosthodontics and Biomaterials, School of Dental Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Stefan Paul
authors.initials: SP
authors.lastname: Hicklin
authors.affiliation: Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
authors.forename: Esther
authors.initials: E
authors.lastname: Schneebeli
authors.affiliation: Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
authors.forename: Vivianne
authors.initials: V
authors.lastname: Chappuis
authors.affiliation: Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
authors.forename: Simone Francesco Marco
authors.initials: SF
authors.lastname: Janner
authors.affiliation: Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Buser
authors.affiliation: Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
authors.forename: Urs
authors.initials: U
authors.lastname: Brägger
mesh_terms: D000328:Adult; D000368:Aged; D003758:Dental Implantation, Endosseous / Q000379:methods; D019094:Dental Prosthesis, Implant-Supported; D005260:Female; D006801:Humans; D057927:Hydrophobic and Hydrophilic Interactions; D057893:Immediate Dental Implant Loading; D007576:Jaw, Edentulous, Partially / Q000601:surgery*; D008297:Male; D008334:Mandible / Q000601:surgery; D008875:Middle Aged; D011446:Prospective Studies; D013499:Surface Properties; D014025:Titanium
chemical_list: D014025:Titanium
keywords: dental implants; early loading; hydrophilic implant surface; late implant placement