Effects of different loading protocols on the secondary stability and peri‐implant bone density of the single implants in the posterior maxilla

Abstract

The peri-implant bone of early-loaded implants was significantly denser than that of immediate- and delayed-loaded implants, 1 year after placement. Density increment can be judged as the radiological findings of loaded-bone, which may also reduce the need for histomorphometric analysis of human biopsy to evaluate the bone reaction around the implants.

Scanning Electron Microscope (SEM) Evaluation of the Interface between a Nanostructured Calcium-Incorporated Dental Implant Surface and the Human Bone

“…The posterior maxilla is generally characterized by a rather poor bone quality compared to other anatomic sites, and is therefore one of the most dangerous sites in the positioning of dental implants [6,8,9,12,13,18]. Furthermore, in our study, the implant was subjected to immediate functional loading.…”

“…Immediate loading represents an additional risk factor for implant failure in the short term, especially in the posterior maxilla, and in the case of single, non-splinted implants [6,8,9,12,13,18]. In fact, the scientific literature supports the concept that micro-movements transmitted by occlusal forces and oral tissues (lips, cheeks, tongue) to the bone-implant interface, above a certain threshold, may jeopardize osseointegration, and determine the mobilization and failure of the implant [5,6,7,8,9,12,13]. Finally, in our present SEM study, we report on the results obtained with an implant of standard dimensions (3.5 mm diameter × 10 mm length), and not with transitional nor temporary implants of reduced dimensions, like in previous studies [16,19].…”

“…Consequently, clinicians more and more often propose and use early [7,9] and immediate [8,10,11] loading protocols; this also takes place in areas characterized by poor bone quality (density) or quantity, and therefore is subjected to greater risk of failure [7,8,12]. …”

“…However, they pose a challenge, as the prosthetic load in the first healing period can result in micro-movements at the bone-implant interface, which beyond a certain threshold may lead to fibrous encapsulation of the fixture, and to the failure of osseointegration [12,13]. …”

“…This may allow the clinician to anticipate the functionalization of the implant, even in difficult clinical contexts (situations with poor bone quality), and to propose and use early and immediate prosthetic loading protocols [7,8,9,10,11,12,18,19,20]. …”