Immediate vs. delayed loading in the posterior mandible: a split-mouth study with up to 15 years of follow-up
, , , . Immediate vs. delayed loading in the posterior mandible: a split-mouth study with up to 15 years of follow-up. Clin. Oral Impl. Res. 00, 2014, 1–6 doi: 10.1111/clr.12542
Abstract
Purpose
The
aim of this study was to evaluate the long-term clinical and
radiographic outcomes of implants that were immediately loaded in a
prospective, randomized, split-mouth clinical trial in the posterior
mandible.
Materials and methods
Patients
with alveolar ridges that were bilaterally edentulous distal to the
canines were enrolled to participate. On one randomly selected side of
each patient's jaw, three implants (control group) with platform
switching and a progressive thread design were placed, allowed to heal
for 3 months, uncovered, and loaded occlusally using resin-splinted
crowns, which then were replaced 6 weeks later by final prostheses.
Three additional implants (test group) of the same size and design were
placed on the contralateral side of each patient in symmetrical
locations. The test implants were connected to their final abutments
immediately after placement and immediately loaded. Periodontal indices
and bone loss were evaluated at regular intervals.
Results
After
a mean loading period of 12.14 (±0.89) years for the test group and
12.40 (±0.89) years for controls, differences between the immediately
and delayed loaded implants were not statistically significant (P > 0.05).
The crestal bone loss was (mesial) 0.70 (±1.09) mm (test group) and
1.17 (±1.27) mm (control group) and the distal bone loss was 0.43
(±1.02) mm (test group) and 1.06 (±1.33) mm (control group) (P > 0.05).
The maximum crestal bone loss was 3.12 mm for the test group and
3.78 mm for the controls after 10.125/10.397 years, respectively.
Conclusion
Immediate
loading does not negatively influence the long-term prognosis of dental
implants in the posterior mandible, improves the implant stability, and
is associated with minimal crestal bone loss when platform switching
and a one-abutment concept with a Morse-tapered connection are used.
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