Full arch immediate occlusal loading using site specific implants: A clinical series of 10 patients (13 arches)

Abstract

Osseointegration of dental endosseous implants has proven to be effective, predictable, and clinically successful. Unloaded healing protocols were originally used in treating edentulous patients. Full arch immediate occlusal loading protocols have been shown to be as effective as unloaded healing protocols. This paper reports on the results, benefits, and limitations of one specific immediate loading protocol using site specific implants for fresh extraction and healed extraction sites. Materials and methods: Ten consecutive patients [{13 arches} (age range: 64-81 years; average: 70.1) (4 males/6 females) were treated by the first 2 authors in private practice settings. Hopeless teeth were scheduled for extraction with immediate implant placement and immediate loading with insertion of full arch, screw-retained, acrylic resin interim prostheses within 24 hours. Implants were also placed into healed edentulous ridges. Insertion torque values for each implant were recorded. Interim prostheses were removed after at least 3 months of healing. Implants were reverse torque tested (35 Ncm) and evaluated for macroscopic mobility. Definitive full arch prostheses were made. Patients were followed for 21 to 48 months postimplant surgery. Panoramic radiographs were taken immediately postimplant placement and 1 year postoperative. Results: Thirteen arches were treated; 11 ultrawide diameter implants were placed into molar sockets, 26 inverted body-shift implants were placed into anterior sockets; 25 standard diameter, tapered implants were placed into edentulous sites; 2 zygomatic implants were placed in one patient. The total number of implants placed was 64 (4 preexisting implants were also used and not included in this study). The minimum implant insertion torque value was 20 Ncm. After 12 to 18 months of function (average 14 months), the implant and prosthetic survival rates were 100%. Eight patients were restored with definitive zirconia or acrylic resin hybrid fixed prostheses. Two patients were restored with bar titanium frameworks and removable overdenture prostheses. No prosthetic complications were reported for the definitive prostheses. Conclusions: The results of this clinical series with site specific implants and immediate full arch occlusal loading in treating edentulous patients resulted in 100% clinical implant and prosthetic survival rates. According to this study, this protocol can be used with high levels of anticipated success. K E Y W O R D S full arch immediate occlusal loading, inverted body, site-specific implants, ultrawide 204

Utilization of Digital Periodontal and Restorative Dentistry in Full Mouth Reconstruction: A Case Report

“…In a clinical series involving dental implants and immediate loading for the management of edentulous patients, the results demonstrated a 100% survival rate for both implants and prosthetics. The study indicated that the protocol can be used with a high level of anticipated success [ 17 ].…”

Immediate Loading of Implants with Fixed Rehabilitations in Geriatric Edentulous Patients; Biological Complications

“…Several clinical studies reported favorable long-term evidence of fixed prosthetic rehabilitation by immediate loading of implants. This clinical protocol can be a general treatment strategy for fully edentulous arches in geriatric patients [37][38][39]. However, the available evidence suggests that a higher incidence of biological and technical complications is reported with complete-arch fixed dental prostheses [33,40,41].…”

Ultrastructural studies on implants failure with immediate or late loading

“…From the statistical analysis performed, it appears that, for the analyzed cases, the degree of ossification (Ca/P ratio) was better represented for the immediate loading, compared to the late loading. Currently, immediate loading [14][15][16][17] is increasingly used with good long-term results, but also for the fastest possible reintegration of patients into society.…”