Conventional and early loading of unsplinted ITI implants supporting mandibular overdentures

Abstract

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.

The Effect of Age, Gender, and Insertion Site on Marginal Bone Loss around Endosseous Implants: Results from a 3-Year Trial with Premium Implant System

“…The present study showed a 98.7% success rate after 3 years, with an average MBL of 0.9 ± 0.1 mm in the maxilla and 0.7 ± 0.2 mm in the mandible, a consistent behaviour within the accepted limits for MBL according to the current literature [6–9], although longer followups will be needed for decisive conclusions. The overall success rate was well within the limits indicated by the literature, and with the only exception of one implant, for which no plausible clinical explanation could be adduced, failures were limited to implants in sites treated with guided bone regeneration procedures.…”

“…Limited resorption around implants is generally considered normal [4, 5] and most reports agree that MBL should not exceed 1 mm at 1 year after prosthesis positioning [6–9], although values up to 2 mm have been reported [10]. A recent review [8] found that few implant systems have any published data about MBL and concluded that this piece of information should be available in the scientific literature for all dental implant systems on the market.…”

A randomized, 12-month controlled trial to evaluate non-inferiority of early compared to conventional loading of modSLA implants in single tooth gaps

“…Clinical data have shown that SLA implants can have very high success rates after 5 years following restoration after 6 weeks in type I to III bone and after 12 weeks in type IV bone, in both fully edentulous and partially edentulous patients and in both the mandible and maxilla [45–48], with stable crestal bone levels over 5 years [49]. Predictable early loading of SLA implants with maxillary full-arch prostheses [50] and mandibular overdentures [51] has also been observed.…”

Effect of loading time on the survival rate of anodic oxidized implants: prospective multicenter study

“…Some randomized controlled trials supported immediate or early loading concept in the full-arch restorations for the success of implant osseointegration 4-6. In a meta-analysis study of 13 prospective trials by Ioannidou et al, early implant loading, whether in partial or full arch, was not found to be associated with worse outcomes compared to the conventional loading 7.…”