Immediate versus delayed loading of single mandibular molars. One-year results from a randomised controlled trial. Replacement of mandibular molars with single-unit restorations supported by wide-body implants: immediate versus delayed loading. A randomized controlled study. Immediate loading versus immediate provisionalization of maxillary single-tooth replacements: a prospective randomized study with BioComp implants. Immediate versus early loading of flapless-placed implants supporting maxillary full-arch prostheses: a randomised controlled clinical trial. Implant-retained mandibular overdentures with Brånemark System MKII implants: a prospective comparative study between delayed and immediate loading. Immediate versus early loading of two implants placed with a flapless technique supporting mandibular bar-retained overdentures: a single-blinded, randomised controlled clinical trial. Immediate versus early loading of 7-mm-long flapless-placed single implants: a split-mouth randomised controlled clinical trial. In-patient comparison of immediate and conventional loaded implants in mandibular molar sites within 12 months. Immediate occlusal versus non-occlusal loading of single zirconia implants. A multicentre pragmatic randomised clinical trial. Immediate non-occlusal loading of single implants in the aesthetic zone: a randomized clinical trial. Early loading of ITI implants supporting a maxillary full-arch prosthesis: 1-year data of a prospective, randomized study. Immediate and early non-occlusal loading of Straumann implants with a chemically modified surface (SLActive) in the posterior mandible and maxilla: interim results from a prospective multicenter randomized-controlled study. Clinical and radiographic evaluation of implant-retained mandibular overdentures with immediate loading. Immediate versus early non-occlusal loading of dental implants placed flapless in partially edentulous patients. One-year results from a randomised controlled trial. Implant-retained mandibular overdentures with ITI implants. Conventional and early loading of unsplinted ITI implants supporting mandibular overdentures. Effect of flapless implant surgery on soft tissue profile: a randomized controlled clinical trial. Instant provisionalization of immediate single-tooth implants is essential to optimize esthetic treatment outcome. Restoration of partially edentulous patients using dental implants with a microtextured surface: a prospective comparison of delayed and immediate full occlusal loading. Early versus late loading of unsplinted TiUnite surface implants supporting mandibular overdentures: a 2-year report from a prospective study. Immediate nonocclusal versus early loading of dental implants in partially edentulous patients: 1-year results from a multicenter, randomized controlled clinical trial. Early loading of unsplinted implants supporting mandibular overdentures using a one-stage operative procedure with two different implant systems: a 2-year report. Immediate functional loading of implants in single tooth replacement: a prospective clinical multicenter study. Immediate versus delayed loading of dental implants placed in fresh extraction sockets in the maxillary esthetic zone: a clinical comparative study. A randomized controlled clinical trial of conventional and immediately loaded tapered implants with screw-retained crowns.
To compare the outcome of immediate non-occlusal loading and that of delayed implant loading in the bilateral replacement of single mandibular molars.
                This study was designed as a randomised, controlled, split-mouth trial. Twenty patients with bilaterally missing first mandibular molars had one of the sites to be restored randomly assigned to be treated with immediately or conventionally loaded single implants. A total of 40 implants were bilaterally installed. All the implants were inserted in healed healthy bone with an insertion torque between 35 and 45 Ncm. One molar was restored with a non-occluding temporary crown within 24 h after implant placement, while the contralateral molar was restored with a definitive crown 4 to 5 months later, according to a two-stage procedure. Final restorations were provided 4 to 5 months after implant placement for all implants. Outcome measures were implant survival, complications, radiographic marginal bone-level changes, PPD and BOP.
                No patients dropped out and no implant failed. Only minor prosthetic complications were observed (2 provisional acrylic crown fractures in the immediate loading group and 2 ceramic chipping in the delayed loading group). Mean marginal bone loss was 0.83 ± 0.16 mm (95% CI 0.75 to 0.91) in the immediate loading group and 0.86 ± 0.16 mm (95% CI 0.78 to 0.94) in the conventional loading group and no statistically significant differences between the two groups were observed (P = 0.530). Mean PPD and BOP values were, respectively, 2.76 ± 0.48 (95% CI 2.55 to 2.97) and 1.30 ± 0.73 (95% CI 0.98 to 1.62) in the immediate loading group, and 2.70 ± 0.37 (95% CI 2.54 to 2.86) and 1.40 ± 0.75 (95% CI 1.07 to 1.73) in the conventional loading group. Also, a statistical comparison of BOP and PPD did not show any significant difference (P = 0.163 and P = 0.652, respectively).
                Within the limitations of this study, the present data seem to confirm the hypothesis that the clinical outcome of immediate versus delayed loading of implants in single mandibular molar sites is comparable. This prospective randomized controlled trial aimed to compare single implant-supported mandibular molar restorations using either an immediate or a delayed loading protocol.
                Thirty subjects requiring single mandibular molar replacement were consecutively treated. One implant was placed in each patient. Fifteen subjects were assigned to delayed loading protocol and 15 to immediate loading protocol according to a randomization table. After insertion, the delayed loaded implants were connected to a healing abutment and restored after 3 to 4 months of healing without loading. The immediately loaded implants were loaded within 24 hours of surgery with a provisional restoration. The interim prosthesis was placed in centric occlusion. All contacts in lateral excursions were eliminated. At implant placement the maximum value of insertion torque was recorded. Radiographic bone level change was measured on periapical radiographs obtained at the time of implant placement and 12 months after loading. Means of the 2 groups were compared by Student t test and analysis of variance (ANOVA). The level of significance was set at .05.
                No implants were lost in the delayed loading group (0/15), whereas 1 implant failed (1/15) in the immediate loading group. No differences were observed in relation to implant length or insertion torque between the groups. The average radiographic bone level change after 1 year of function was 1.2 +/- 0.55 mm (range, 0.5 to 2.6 mm) and 0.77 +/- 0.38 mm (range, 0.29 to 1.23 mm) for the delayed loaded and the immediately loaded implants, respectively. The difference in radiographic bone level change between the delayed and immediate loading groups was statistically significant (P = .022; CI = -0.79 to -0.06; Student t test).
                Immediate loading of wide-diameter implants supporting single restorations in mandibular molar sites seems to be a suitable clinical option. Moreover, the radiographic bone level change observed after 12 months of loading was significantly less for immediately loaded implants. The aim of this prospective randomized study was to evaluate the clinical outcome of immediately loaded solid plasma sprayed (TPS) BioComp (BioComp Industries BV, Vught, The Netherlands) implants versus immediate provisionalized but non-loaded BioComp implants in the anterior and premolar region of the maxilla.
                Forty-eight patients (31 females and 17 males) with a mean age of 42.3+/-13.1 years (range 19 to 78 years) were included in the study. Fifty threaded TPS implants were placed and provisionalized within 24 hours after surgery. The patients were randomly assigned to 2 groups. In the immediate loaded (IL) group (n=24) the occlusion of the provisional was designed with normal contacts in centric relation and at lateral excursions, while in the non-immediate loaded (IP) group (n=24) the provisional restoration was adjusted to clear all occlusal contacts or contacts at lateral excursions. Patients were instructed to eat a soft diet and to avoid placing food in the area of the provisional crown during the first 6 weeks. Regular clinical and radiographic controls were performed and the survival rate and implant stability quotient (ISQ) values were evaluated at delivery of the definitive restoration at 6 months. At 1 year, radiographic coronal bone defects and gingival esthetics between the 2 groups were assessed.
                Of the IL group, 2 fixtures were lost, while 3 implants were lost in the IP group. The failing implants showed increasing mobility at 2 to 3 weeks after insertion, and were removed. The remaining 45 implants were stable at every subsequent follow-up examination, and 6 months after implant placement, ISQ values were measured. The mean ISQ value in the IL group was 63.7+/-5.8 versus 63.2+/-4.3 for the IP group (P=.78). The mean mesial marginal bone loss after 12 months in the IL group was 0.27+/-0.2 mm versus 0.28+/-0.22 mm in the IP group (P=.9). The mean distal marginal bone loss after 12 months in the IL group was 0.19+/-0.15 mm versus 0.2+/-0.11 mm in the IP group (P=.87). All implants of the IL group had an ideal gingival buccal margin, versus 91% of the IP group. Full regeneration of the mesial interdental papilla was observed in 70% of the IL group versus 91% of the IP group, while full regeneration of the distal papilla was observed in 91% of both the IL and IP implants.
                No significant differences in ISQ mean values in radiographic bone loss and gingival esthetics were found between immediate non-loaded provisionalization and immediately loaded BioComp implants in the maxilla. To evaluate the efficacy of flapless placed implants immediately or early loaded at 2 months with full-arch prostheses.
                Thirty patients were randomised: 15 to the immediately loaded group and 15 to the early loaded group. All implants had to be inserted with a minimum torque > 48 Ncm. Outcome measures were prosthesis and implant failures, biological and biomechanical complications, peri-implant marginal bone level changes, patient satisfaction and implant stability quotient (ISQ) assessed with a resonance frequency analysis instrument.
                Ninety implants were placed in the immediately loaded and 87 in the early loaded group. Four localised flaps had to be elevated. Six implants in five patients did not reach the planned insertion torque. Four were immediately replaced by larger diameters ones, one was early loaded and another removed just after placement. After 1 year no drop-out occurred. One implant failed in the immediately loaded group versus three early loaded implants in two patients. There were no statistically significant differences between groups for implant losses, complications, and mean marginal bone level changes. There were borderline significant differences for mean ISQ values, and patients in the immediately loaded group were significantly more satisfied than those early loaded. When comparing mean ISQ values taken 2 months after placement with year 1 data within each group, values increased significantly.
                Maxillary cross-arch prostheses can be successfully loaded the same day of flapless implant placement, increasing patient satisfaction while decreasing treatment time and patient discomfort. No apparent advantages were seen when loading implants at 2 months. This study was designed to compare the results of immediate and delayed loading of implants with implant-retained mandibular overdentures. Ten patients (test group) received 40 Brånemark System MKII implants (4 per patient) placed in the interforaminal area of the mandible. Standard abutments were immediately screwed to the implants, rigidly connected with a bar, and immediately loaded with an overdenture. Ten patients (control group) received the same type and number of implants in the same area, but the implants were left to heal submerged. Four to 8 months later, standard abutments were screwed to the implants and the same prosthetic procedure was applied. Each implant was evaluated at the time of prosthetic loading and at 6, 12, and 24 months after the initial prosthetic load with the following parameters: modified Plaque Index (MPI), modified Bleeding Index (MBI), probing depth (PD), and Periotest. Peri-implant bone resorption was evaluated on panoramic radiographs taken 12 and 24 months after initial prosthetic loading. No significant differences were found between the 2 groups regarding MPI, MBI, Periotest, peri-implant bone resorption, and PD at 6 and 24 months (P > .05). The only difference was found regarding PD values on the mesial and lingual sites at 12 months (P < .05). The cumulative success rate of implants was 97.5% in both groups. Results from this study showed that immediate loading of endosseous implants rigidly connected with a U-shaped bar does not seem to have any detrimental effect on osseointegration. Conversely, this method significantly shortens the duration of treatment with relevant satisfaction for the patients. 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.
                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.
                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.
                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. To evaluate the efficacy of 7-mm-long flapless placed single implants immediately or early loaded at 6 weeks.
                Thirty patients received two single Nanotite External Hex Biomet 3i implants that were then randomised for immediate or early loading. All implants had to be inserted with a minimum torque >40Ncm. Provisional crowns were put in slight occlusal contact and replaced by definitive crowns 3 months after loading. Outcome measures were implant failures, biological and biomechanical complications, peri-implant marginal bone level changes and patient preference.
                Twenty-nine implants were immediately loaded and 31 early loaded. Thirteen flaps had to be elevated in 12 patients. Eleven implants in ten patients did not reach the planned insertion torque. Eight implants in seven patients were immediately replaced by implants with a larger diameter, two were loaded anyway, and one implant that was randomised to immediate loading was early loaded instead. Nine months after loading, no drop-out occurred. One implant failed in each group. There were no statistically significant differences between groups for implant losses, complications, mean marginal bone level changes, and patient preferences.
                Flapless placed 7-mm-long single implants can be successfully loaded the day of insertion. Longer follow-ups are needed to monitor the long-term prognosis of short implants. The aim of this prospective clinical study was to evaluate the clinical outcomes of dental implants placed in the mandibular molar sites and immediately functionally restored compared with conventionally loaded controls in an in-patient study.
                Twenty-four dental implants were placed in 12 patients who had first molar loss bilaterally in the mandibular area. One site of the patient was determined as immediately loaded (IL) and the other side was conventionally loaded (CL). Resonance frequency analyses for implant stability measurements, radiographic examinations for marginal bone levels and peri-implant evaluations were performed during the clinical follow-up appointments within 12 months.
                During the 12-month follow-up period, only one implant was lost in the IL group. The mean implant stability quotient values were 74.18+/-5.72 and 75.18+/-3.51 for Groups IL and CL at surgery, respectively, and the corresponding values were 75.36+/-5.88 and 75.64+/-4.84 at 1-year recall, respectively. The difference was not statistically significant between the two groups during the 12-month study period (P>0.05). When peri-implant parameters were evaluated, excellent peri-implant health was demonstrated during the 1-year observation period and all implants showed less than 1 mm of marginal bone resorption during the first year.
                In the present study, immediate functionally loading did not negatively affect implant stability, marginal bone levels and peri-implant health when compared with conventional loading of single-tooth implants. To evaluate whether immediate non-occlusal loading of single zirconia implants could reduce early failures when compared to immediate occlusal loading.
                Forty partially edentulous patients who received one single zirconia implant (Z-Systems) at least 10 mm long and 3.25 mm wide inserted with a torque of at least 35 Ncm were randomised to immediate occlusal or non-occlusal loading groups. All patients received provisional acrylic crowns the same day of implant placement. Provisional crowns were replaced after 4 to 5 months by definitive full ceramic crowns. Outcome measures were implant success, any complications and peri-implant marginal bone levels.
                One year after loading, no patients had dropped out. Five implants (12.5%) failed early: three occlusally loaded and two non-occlusally loaded. Three complications occurred, all after delivery of the definitive crowns: one crown fractured (occlusal loading), one had to be remade after debridement because of hyperplastic tissues (occlusal loading), and one crown decemented (nonocclusal loading). These differences were not statistically significant. Both groups gradually lost periimplant bone in a highly statistically significant way. One year after loading, patients subjected to non-occlusal loading lost an average of 0.7 mm of peri-implant bone versus 0.9 mm in the occlusal group. This difference in bone loss between groups was not statistically significant. There was an association between immediate post-extractive implants and implant failures (P=0.01). Four of the 10 immediate post-extractive implants (40%) failed versus one out of 30 delayed implants (3%).
                The results of this study do not provide a conclusive answer to whether immediate non-occlusal loading may decrease implant failures. Immediately loaded zirconia implants placed in post-extractive sites had high failure rates. this study compared the outcome of immediate non-occlusal loading with conventional loading for single implants in the maxillary aesthetic zone. It was hypothesized that immediate non-occlusal loading is not inferior to conventional loading.
                sixty-two patients with a missing maxillary anterior tooth were randomly assigned to be treated with an implant that was either restored with a non-occluding temporary crown within 24 h after implant placement (the "immediate group") or was restored according to a two-stage procedure after 3 months (the "conventional group"). All implants were installed in healed sites. Follow-up visits were conducted after 6 and 18 months post-implant placement. Outcome measures were radiographic marginal bone-level changes, survival, soft tissue aspects (probing depth, plaque, bleeding, soft tissue level), aesthetics and patient satisfaction.
                no significant differences were found between both study groups regarding marginal bone loss (immediate group 0.91 ± 0.61 mm, conventional group 0.90 ± 0.57 mm), survival (immediate group 96.8%: one implant lost, conventional group 100%), soft tissue aspects, aesthetic outcome and patient satisfaction.
                within the limitations of this study (sample size, follow-up duration), it was demonstrated that, for single implants in the anterior maxilla, the outcome of immediate non-occlusal loading was not less favourable than conventional loading. This prospective, randomized study investigated the safety, feasibility, and reliability of the early loading of implants in edentulous maxillae.
                Twenty-four patients with completely edentulous maxillae were randomized into a test group (n = 16) and a control group (n = 8). All patients received 5 or 6 solid screw-type titanium implants. These were loaded with full-arch prostheses after 9 to 18 days in the test group and after 2.5 to 5.1 months in the control group. Periapical radiographs were taken and routine clinical assessments were made at loading, after 6 months, and after 12 months.
                The implant survival rate 1 year after loading was 100%. Modified Plaque index scores and Sulcus Bleeding index scores were better in the test group than in the control group (P < or = .05). There was a significant difference in peri-implant bone height between the 2 groups (P < .001) and this difference converged with time (P < .001).
                This clinical, prospective, randomized, controlled study fulfilled the criteria for a comparable study. Owing to the small patient sample, the conclusions drawn were based on feasibility analyses of the results. Standard materials and methods were used. Only patients with maxillary bone of sufficient height and width were selected. The use of a single operator in each discipline--maxillofacial surgery, prosthodontics, and dental technology--may have improved the chances of achieving consistent standards and opinions.
                These results indicate that early loading in selected patients was as safe and reliable as delayed loading in this small patient population and may offer a satisfactory alternative to the standard protocol. Immediate and early loading of dental implants can simplify treatment and increase overall patient satisfaction. The purpose of this 3-year prospective randomized-controlled multicenter study was to assess the differences in survival rates and bone level changes between immediately and early-loaded implants with a new chemically modified surface (SLActive). This investigation shows interim results obtained after 5 months.
                Patients > or =18 years of age missing at least one tooth in the posterior maxilla or mandible were enrolled in the study. Following implant placement, patients received a temporary restoration either on the day of surgery (immediate loading) or 28-34 days after surgery (early loading); restorations consisted of single crowns or two to four unit fixed dental prostheses. Permanent restorations were placed 20-23 weeks following surgery. The primary efficacy variable was change in bone level (assessed by standardized radiographs) from baseline to 5 months; secondary variables included implant survival and success rates.
                A total of 266 patients were enrolled (118 males and 148 females), and a total of 383 implants were placed (197 and 186 in the immediate and early loading groups, respectively). Mean patient age was 46.3+/-12.8 years. After 5 months, implant survival rates were 98% in the immediate group and 97% in the early group. Mean bone level change from baseline was 0.81+/-0.89 mm in the immediate group and 0.56+/-0.73 mm in the early group (P<0.05). Statistical analysis revealed a significant center effect (P<0.0001) and a significant treatment x center interaction (P=0.008).
                The results suggested that Straumann implants with an SLActive can be used predictably in time-critical (early or immediate) loading treatment protocols when appropriate patient selection criteria are observed. The mean bone level changes observed from baseline to 5 months (0.56 and 0.81 mm) corresponded to physiological observations from other studies, i.e., were not clinically significant. The presence of a significant center effect and treatment x center interaction indicated that the differences in bone level changes between the two groups were center dependent. The aim of this study was to evaluate and compare immediate-loaded implant-retained mandibular overdentures and delayed-loaded implant-retained mandibular overdentures.
                Ten completely edentulous male patients received 40 dental implants. Patients were randomly divided into 2 equal groups, 5 patients each. Patients of both groups received conventional maxillary complete denture and had stage 1 surgery for placing 4 dental implant fixtures, 2 on each side anterior to the mental foramina. Group A: One-stage surgical procedure and immediate loading. Patients in this group received mandibular bar-retained overdenture supported by 4 endosseous implants loaded immediately after implant placement. Group B: The original 2-stage concept and delayed loading. Patients in this group received mandibular bar-retained overdenture supported by 4 endosseous implants that remained submerged for a period of 4 months before loading. The patients were evaluated clinically and radiographically immediately after overdenture delivery and after 6 months, 12 months, 18 months, and 24 months.
                The results of clinical evaluation showed no statistical significant difference between the 2 groups regarding the effect of treatment. The radiographic assessment showed no statistical significant difference in mesial and distal alveolar bone loss at the different intervals of the follow-up period, except at the 12-month period, where immediately loaded implants showed a decrease in the amount of alveolar bone loss mesially and distally compared to delayed loaded implants.
                The results suggest that immediate-loaded implants provide promising results compared to delayed-loaded implants and can be a possible alternative procedure in implant dentistry. To compare immediate versus early (6 weeks) non-occlusal loading of dental implants placed flapless in partially edentulous patients 1 year after loading.
                Sixty patients were randomised: 30 to the immediately loaded group and 30 to the early loaded group. In order to be immediately loaded, implants were inserted with a minimum torque of > or = 40Ncm. Implants were fully occlusally loaded after 6 months. Outcome measures were prosthesis and implant failures, and biological and biomechanical complications.
                Five implants in five patients randomised to the immediately loaded group did not reach the required primary implant stability. Three of these implants (two prostheses) were not immediately loaded. Two patients who were randomised to the early loaded group were immediately loaded erroneously. Implants in five patients of the early loaded group were conventionally loaded. No patient dropped out and there were no failures. Two complications occurred in the early and one in the immediately loaded group (no statistically significant difference), but were solved.
                The use of a flapless technique for placing dental implants in conjunction with non-occlusal immediate or early loading in selected patients can provide excellent clinical results. No differences were observed when comparing implants that were loaded immediately or early. Therefore, when a high primary implant stability is obtained, it might be preferable to load the implants immediately rather than waiting for a few weeks. This prospective study has been designed to compare the results of immediate and delayed loading of implant-retained mandibular overdentures after a 2-year follow-up. Twenty patients have been randomly divided into two groups. Group 1 patients (test group) received four ITI implants in the intraforaminal area of the mandible. Octa abutments were immediately screwed on implants; 2 days after surgery, the implants were rigidly connected with a U-shaped Dolder gold bar and loaded with an overdenture. Group 2 patients (control group) received, in the same area, the same type and number of implants, which were left to heal according to the standard protocol. At 3-4 months, Octa abutments were screwed on the implants and the same prosthetic procedure of the test group was applied. The minimum follow-up period lasted 2 years, with recall appointments at 2 weeks, 1, 3, 6 months, 1 year and every following year postoperatively, evaluating: MPI, MBI, PD, Periotest and radiographic peri-implant bone resorption. Success criteria according to Albrektsson et al. were used. Only one implant out of the 40 of group 2 failed, whereas none failed in group 1. No statistical difference of the clinical parameters evaluated was noticed in the two groups. Therefore, immediate loading of implants, if connected with a U-shaped bar, can provide the same results of the 'traditional' technique as far as osseointegration and short-term survival rates of implants are concerned. Moreover, this method significantly shortens the treatment period, thus increasing patient satisfaction. The aim of this study was to compare the success rates after 1 and 2 years of conventionally and early loaded pairs of unsplinted ITI implants supporting mandibular overdentures in edentulous patients. Twenty-four participants (age range 55-80 years) were randomly allocated with maximum concealment to two treatment groups. In the first group, the implants were allowed to heal for 12 weeks before being functionally loaded (control) and the second group had 6 weeks of healing with identical loading. All participants had new conventional complete maxillary and mandibular dentures prior to the study. Two sandblasted large-grit acid-etched (SLA) surface ITI implants were placed in the mandibular interforaminal area, following a standardized nonsubmerged surgical protocol. After 6 or 12 weeks of healing, matrices were processed into the fitting surface of the pre-existing mandibular dentures and the implants loaded. Implant success was determined using mobility tests and radiographs taken at baseline and 52 and 104 weeks after surgery. Clinical peri-implant parameters were also documented. Results showed all implants successfully osseointegrated, according to accepted criteria, after 2 years. Mean loss of crestal bone height after 1 year was 0.35 +/- 0.22 mm (control) vs. 0.27 +/- 0.18 mm (test). After 2 years this reduced to 0.09 +/- 0.06 mm (control) vs. 0.12 +/- 0.17 mm (test). The mean Periotest value after 1 year was -4.9 (control) vs.-3.78 (test). After 2 years, the mean resonance frequency value for the control implants was 6797 Hz [mean implant stability quotient (ISQ) = 64.77] and for the test implants 6670 Hz (mean ISQ = 62.0). Shortened loading periods for these ITI implants did not cause any statistically significant differences in osseointegration or peri-implant parameters. We conclude that pairs of unsplinted SLA-surface ITI implants can be successfully loaded with mandibular overdentures 6 weeks after surgery. Flapless implant surgery has been suggested as one possible treatment option for enhancement of implant esthetics.
                Twenty-four patients with a missing tooth in the premaxillary region were randomly assigned to one of two groups (12 each): immediate loading (IL) or delayed loading (DL) (loading after 4 months). An endosseous implant was placed in each patient via a flapless surgery. Clinical measurements including the papillary index (PPI) (0, no papilla; 1, less than half; 2, more than half but not complete fill; 3, complete fill; and 4, overfill), marginal levels of the soft tissue (ML), probing depths (PDs), modified bleeding index (mBI), modified plaque index (mPI), and the width of the keratinized mucosa (WKM) were performed at baseline (at the time of loading) and at 2, 4, and 6 months.
                The soft tissue profile remained stable up to 6 months, without significant differences between the two groups (mean PPI and ML at 6 months, 2.16 and 0.30 mm, respectively). Mean PPI in the IL group significantly increased from 1.50 at baseline to 2.09 at 2 months, and the significance remained up to 6 months (2.30 at 6 months) (P <0.05), whereas in the DL group, no significant changes were found from baseline to 6 months in mean PPI (2.06 at both time points). Mean PPI increased over time when two treatment groups were combined; however, no statistical significance was found. In ML, the difference at baseline between the two groups (-0.28 mm for DL versus 0.17 mm for IL; P <0.05) was no longer significant at 2 months (0 versus 0.08 mm for DL and IL, respectively) and thereafter (P >0.05). No significant differences were detected between groups at each time and over time in the other clinical parameters, PD, mBI, mPI, and WKM (P >0.05).
                The results of this study indicate that creeping attachment (i.e., soft tissue recovery) might occur within 2 months after IL. The study suggests that flapless implant surgery provides esthetic soft tissue results in single-tooth implants either immediately or delayed loaded. Other long-term randomized controlled clinical trials with a large sample size and comparison group (i.e., implant surgery with flap) are recommended to verify the conclusions drawn in this preliminary study. The immediate single-tooth implant has become a viable treatment option. However, the impact of the restorative procedure on esthetics is currently unclear. The goal of this study was to compare the soft tissue outline at immediate implants following two restorative protocols: immediate connection of a temporary crown or submerged healing during which a removable partial denture is used.
                A 1-year single-blind randomized clinical study was performed in 49 patients. Twenty-four patients were assigned to the immediate restoration group and 25 to the delayed restoration group. Clinical and radiographic evaluations of soft and hard tissues were carried out after 3, 6 and 12 months.
                Implant survival, bone remodeling, probing depth and bleeding tendency were not influenced by the restorative protocol. Delayed restoration resulted in initial papilla loss taking up to 1 year to attain comparable height as for immediate restoration. Midfacial recession was systematically 2.5-3 times higher following delayed restoration pointing to a 0.75 mm additional loss in comparison with immediate restoration after 1 year.
                If the primary implant stability permits it, immediate single-tooth implants should be instantly provisionalized in the interest of optimal midfacial esthetics. The aim of this study was to determine the clinical effectiveness of placing dental implants with microtextured surfaces into full occlusal loading at the time of placement in partially edentulous patients.
                Two demographically similar groups of 14 patients each were treated with a total of 92 Spline Twist Implants (Centerpulse Dental, Carlsbad, CA). Test implants were placed into immediate full occlusal loading, and control implants were restored using a conventional delayed loading procedure. Otherwise, both groups of patients received similar therapy from the same treatment team. Radiographs, periodontal indices, and Periotest values were recorded every 6 months during routine clinical follow-up appointments. The mean loading time for all prostheses was 24 months at the time of this report.
                No implants failed in the test group, and 1 implant failed before loading in the control group. Cumulative implant success was 98.9% for all implants placed (test group = 100%; control group = 92.9%). Periodontal measurements indicated no significant clinical differences between implants placed into immediate full occlusal loading and those loaded via a conventional delayed protocol.
                Immediate full occlusal loading of partial prostheses supported by microtextured implants in partially edentulous patients demonstrated excellent clinical results, with no adverse periodontal effects after 24 months of function. Additional follow-up will provide invaluable information on the long-term effects of this technique.
                Immediate full occlusal loading of partial prostheses supported by microtextured implants can be successfully achieved for 24 months in highly motivated patients with excellent oral hygiene. The aim of this study was to evaluate the clinical performance of the implants supporting mandibular overdentures, and to investigate the prosthodontic outcomes of the mandibular implant overdentures. Twenty edentulous patients participated in this study. Forty implants were placed in the canine areas of the mandibles of all patients using the 1-stage approach. New maxillary complete dentures and the mandibular implant overdentures were delivered to 10 patients in the test group 1 week after surgery, while new maxillary and mandibular complete prostheses were delivered to 10 patients in the control group. These conventional mandibular prostheses were converted to mandibular implant overdentures 3 months after surgery. No implants were lost neither in test nor in control group. The average ISQ values between the two groups were not statistically significant during 2 years (P > 0.05). The average marginal bone resorptions were 0.4 and 0.5 mm for the test and the control group after 2 years. The number of appointments required for the prosthodontic maintenance of the mandibular implant overdentures in the first year was higher than that in the second year, which was statistically significant(P < 0.001). The results of the study suggest that the 1-week early loading approach does not adversely influence the clinical performance of the implants supporting mandibular overdentures. To compare the efficacy of immediate nonocclusal loading (test group) versus early loading (control group) in partially edentulous patients.
                Fifty-two patients in 5 Italian private practices were randomized to 1 of the treatments: 25 to the immediately loaded group and 27 to the early loaded group. To be immediately loaded, single implants had to be inserted with a torque of > 30 Ncm, and splinted implants had to be inserted with a torque of > 20 Ncm. Implants in the immediately loaded group were provided with full acrylic resin nonoccluding temporary restorations within 48 hours after placement. After 2 months, full occluding provisional restorations were provided. Implants in the early loading group were not submerged and were loaded after 2 months. At 8 months, provisional restorations were replaced with definitive metal-ceramic prostheses. Outcome measures were prosthesis and implant failures as well as biologic and prosthetic complications recorded by nonblinded assessors. The Fisher exact test was used to compare the proportion of implant failures.
                Fifty-two implants were placed in the immediately loaded group and 52 in the early loaded group. No dropouts or complications occurred up to 14 months postinsertion. One single implant failed in the immediately loaded group 2 months after placement. There was no statistically difference for the tested outcome measures between the 2 procedures (P > .99).
                The results of this randomized controlled clinical trial with 25 patients rehabilitated with immediately restored nonocclusally loaded implant-supported prostheses compared to 27 patients restored 2 months following placement suggest that there are no major clinical differences in implant survival between these 2 protocols. No biologic or prosthetic complications occurred. Step-wise reduction in loading protocols is necessary to evaluate early loading of implants with mandibular overdentures.
                To compare the success rates of two different dental implant systems following conventional or early loading protocols in patients being rehabilitated with mandibular overdentures.
                Forty-eight edentulous participants were randomly allocated to two different implant systems: one with a machined titanium implant surface (Sterioss, Nobel Biocare, Yorba Linda, California, USA) and the other with a roughened titanium surface (Southern Implants, Irene, South Africa). For each system, the participants were further divided into control groups, in whom mandibular implant overdentures and their respective matrices were inserted following a standard 12-week healing period, and test groups, in whom a 6-week healing period was followed prior to identical loading. Two unsplinted implants to support implant overdentures were placed in the anterior mandible of all participants, using a standardized one-stage surgical procedure. Mobility tests and marginal bone levels, as well as peri-implant parameters, were evaluated at each baseline and 52 and 104 weeks after surgery.
                There was no statistically significant difference in the success rates of the two systems in either control or test groups. At the 2-year evaluation, a success rate was found of 87.5% and 70.8% for the control and test Sterioss groups, respectively, and 83.3% and 100% for the control and test Southern Implants groups were observed. For the Sterioss groups, eight implants were lost at an early stage: seven in the test group and one in the control group. For the Southern Implants control and test groups, no failures were seen at any time interval. There were no significant differences in marginal bone loss, Periotest values, and peri-implant parameters between implant systems or between any of the control or test groups.
                Early loading, with step-wise reductions in loading protocols, of unsplinted machined Sterioss and roughened Southern Implants fixtures with mandibular overdentures is possible for up to 2 years. The aim of the present study was to evaluate the outcome of immediate functional loading of implants in single-tooth replacement using two different installation procedures.
                One hundred and fifty-one subjects, who required single-tooth rehabilitation in the area of 15-25 and 35-45, were enrolled in eight private clinics in Italy. The implant sites were randomly allocated to one of the following treatment groups. In the control group, in which a standard preparation procedure for implant placement and submerged healing of the implant was used, abutment connection and loading of the implants were performed 3 months after installation. In the test group 1, a standard preparation procedure for the implant placement and immediate functional loading of implant was carried out. In the test 2 group, however, a modified implant installation procedure (osteotome technique) was used followed by immediate functional loading of the implant. Clinical and radiographic examinations were performed at 3 and 12 months of follow-up at all sites.
                Three implants (5.5%) from the test 2 group (osteotome preparation) and one (2%) from the test 1 group (conventional drill preparation) failed to integrate and were removed one and three months after implant installation. The mean marginal bone loss assessed at 12 months was 0.31 mm (test 1), 0.25 mm (test 2) and 0.38 mm (control) (no statistically significant differences were found between the three treatment groups.)
                It is suggested that immediate functional loading of implants that are placed with a conventional installation technique and with sufficient primary stability may be considered as a valid treatment alternative in a single-tooth replacement. The aim of this study was to report a clinical comparative assessment of crestal bone level change around single implants in fresh extraction sockets in the esthetic zone of the maxilla either immediately loaded or loaded after a delay.
                Forty patients were included in a prospective, randomized study. All patients required 1 tooth extraction (ie, 1 tooth with a hopeless prognosis) and were randomized into either the test group or the control group. Implants were positioned immediately after tooth extraction and were loaded immediately in the test group (20 implants) and after 3 months in the control group (20 implants). The implant site was prepared, with at least 4 mm of sound apical bone below the implant apex, and the coronal margin of the implant was placed at the buccal level of the bone crest. All implants were 13 mm long; 30 implants had a diameter of 5 mm, and 10 had a diameter of 3.75 mm. Radiographic examinations were made at baseline, at 6 months, and at 24 months. To compare the mean values between test and control group, a paired t test was performed (considered statistically significant at P < .05).
                After a 24-month follow-up period, a cumulative survival rate of 100% was reported for all implants. The control group resulted in a mean mesial bone loss of 1.16 +/- 0.32 mm and a mean distal bone loss of 1.17 +/- 0.41 (mean bone loss, 1.16 +/- 0.51 mm). The test group resulted in a mesial bone loss of 0.93 +/- 0.51 mm and a distal bone loss of 1.1 +/- 0.27 mm (mean bone loss, 1.02 +/- 0.53 mm). No statistically significant difference between control and test groups (P > .05) was found.
                The success rate and radiographic results of immediate restorations of dental implants placed in fresh extraction sockets were comparable to those obtained in delayed loading group. Surgical, prosthodontic, and esthetic outcomes of conventional and immediately loaded, single, tapered, roughened-surface Southern implants in the anterior maxilla that were restored with screw-retained crowns were compared over 1 year.
                Standardized surgical and prosthodontic procedures were followed and accepted criteria were used for assessment.
                There were no significant differences within or between the control and test groups for age, gender, bone quality or quantity, implant stability measurements at surgery, or implant length.
                After 1 year, the implants that had been immediately loaded with single provisional crowns at surgery and definitive crowns 8 weeks later were as successful as conventionally loaded 2-stage implants.
Overall there was no convincing evidence of a clinically important difference in prosthesis failure, implant failure, or bone loss associated with different loading times of implants. The quality of the evidence is assessed as very low due to high and unclear risk of bias of primary studies and there is some evidence of reporting bias so clinicians should treat these findings with caution. A high value of insertion torque (at least 35 Ncm) seems to be one of the prerequisites for a successful immediate/early loading procedure. More well-designed RCTs are needed and should be reported according to the CONSORT guidelines (www.consort-statement.org/), and registered with a trials registry.