Immediate functional loading of implants in single tooth replacement: a prospective clinical multicenter study.

OBJECTIVES 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. MATERIAL AND METHODS 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. RESULTS 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.) CONCLUSION 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.

[1]  I Herrmann,et al.  Osseointegrated implants for single-tooth replacement: a prospective 5-year multicenter study. , 1996, The International journal of oral & maxillofacial implants.

[2]  B. Rangert,et al.  Immediate occlusal loading of single lower molars using Brånemark System Wide-Platform TiUnite implants: an interim report of a prospective open-ended clinical multicenter study. , 2003, Clinical implant dentistry and related research.

[3]  M. Norton.  A short-term clinical evaluation of immediately restored maxillary TiOblast single-tooth implants. , 2004, The International journal of oral & maxillofacial implants.

[4]  R. Glauser,et al.  Immediate occlusal loading of Brånemark TiUnite implants placed predominantly in soft bone: 1-year results of a prospective clinical study. , 2003, Clinical implant dentistry and related research.

[5]  J. Wennström,et al.  Implant-supported single-tooth restorations: a 5-year prospective study. , 2005, Journal of clinical periodontology.

[6]  M. Norton,et al.  Marginal bone levels at single tooth implants with a conical fixture design. The influence of surface macro- and microstructure. , 1998, Clinical oral implants research.

[7]  C. Drago,et al.  Immediate provisional restoration of Osseotite implants: a clinical report of 18-month results. , 2004, The International journal of oral & maxillofacial implants.

[8]  I. Shannon,et al.  A clinical report. Water-free stannous-fluoride gel and post-irradiation caries. , 1972, Journal of public health dentistry.

[9]  T Jemt,et al.  3-year followup study of early single implant restorations ad modum Brånemark. , 1990, The International journal of periodontics & restorative dentistry.

[10]  U. Joos,et al.  Biological and biomechanical evaluation of bone remodelling and implant stability after using an osteotome technique. , 2004, Clinical oral implants research.

[11]  R. Palmer,et al.  A 5-year prospective study of Astra single tooth implants. , 2000, Clinical oral implants research.

[12]  S. Rb.  The osteotome technique: Part 4--Future site development. , 1995 .

[13]  R B Summers,et al.  Sinus floor elevation with osteotomes. , 1998, Journal of esthetic dentistry.

[14]  N. Zitzmann,et al.  Sinus elevation procedures in the resorbed posterior maxilla. Comparison of the crestal and lateral approaches. , 1998, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[15]  D Buser,et al.  Long-term evaluation of non-submerged ITI implants. Part 1: 8-year life table analysis of a prospective multi-center study with 2359 implants. , 1997, Clinical oral implants research.

[16]  R. Summers.  The osteotome technique: Part 2--The ridge expansion osteotomy (REO) procedure. , 1994, Compendium.

[17]  D. Dayan,et al.  Immediate loading of single-tooth implants: immediate versus non-immediate implantation. A clinical report. , 2001, The International journal of oral & maxillofacial implants.

[18]  R. Wilson,et al.  A clinical, radiographic, and microbiologic comparison of Astra Tech and Brånemark single tooth implants. , 2000, Clinical implant dentistry and related research.

[19]  R. Palmer,et al.  A prospective study of Astra single tooth implants. , 1997, Clinical oral implants research.

[20]  Michele Leone,et al.  Restoration of partially edentulous patients using dental implants with a microtextured surface: a prospective comparison of delayed and immediate full occlusal loading. , 2003, The International journal of oral & maxillofacial implants.

[21]  B. Rangert,et al.  Immediate functional loading of Brånemark System implants with enhanced initial stability: a prospective 1- to 2-year clinical and radiographic study. , 2003, Clinical implant dentistry and related research.

[22]  Peter K. Hobo,et al.  Freestanding and multiunit immediate loading of the expandable implant: an up-to-40-month prospective survival study. , 2001, The Journal of prosthetic dentistry.

[23]  K. Nilner,et al.  Immediate functional loading of Brånemark single tooth implants. An 18 months' clinical pilot follow-up study. , 2000, Clinical oral implants research.

[24]  Simone Windisch,et al.  Immediate occlusal loading of Brånemark System TiUnite implants placed predominantly in soft bone: 4-year results of a prospective clinical study. , 2005, Clinical implant dentistry and related research.

[25]  L. Cooper,et al.  A multicenter 12-month evaluation of single-tooth implants restored 3 weeks after 1-stage surgery. , 2001, The International journal of oral & maxillofacial implants.

[26]  Summers Rb,et al.  A new concept in maxillary implant surgery: the osteotome technique. , 1994 .

[27]  F. Kloss,et al.  Histomorphometric and fluorescence microscopic analysis of bone remodelling after installation of implants using an osteotome technique. , 2002, Clinical oral implants research.

[28]  Shanaman Rh,et al.  The bone-added osteotome sinus floor elevation technique: multicenter retrospective report of consecutively treated patients. , 1999, The International journal of oral & maxillofacial implants.

[29]  J. Jansen,et al.  A meta-analysis of clinical studies to estimate the 4.5-year survival rate of implants placed with the osteotome technique. , 2007, The International journal of oral & maxillofacial implants.

[30]  Summers Rb,et al.  The osteotome technique: Part 2--The ridge expansion osteotomy (REO) procedure. , 1994 .

[31]  G. Polizzi,et al.  Immediate and early function of Brånemark System implants placed in the esthetic zone: a 1-year prospective clinical multicenter study. , 2003, Clinical implant dentistry and related research.

[32]  Judith Maria Pinheiro Ottoni,et al.  Correlation between placement torque and survival of single-tooth implants. , 2005, The International journal of oral & maxillofacial implants.

[33]  B. Rangert,et al.  Immediate/early loading of dental implants: a report from the Sociedad Española de Implantes World Congress consensus meeting in Barcelona, Spain, 2002. , 2003, Clinical implant dentistry and related research.

[34]  R. Summers.  The osteotome technique: Part 4--Future site development. , 1995, Compendium of continuing education in dentistry.

[35]  H. Haanaes,et al.  Immediate loading of single-tooth ITI implants in the anterior maxilla: a prospective 5-year pilot study. , 2002, Clinical oral implants research.

[36]  Massimiliano Martignoni,et al.  Immediate loading in the maxilla using flapless surgery, implants placed in predetermined positions, and prefabricated provisional restorations: a retrospective 3-year clinical study. , 2003, Clinical implant dentistry and related research.

[37]  Björn Klinge,et al.  A systematic review of the incidence of biological and technical complications in implant dentistry reported in prospective longitudinal studies of at least 5 years. , 2002, Journal of clinical periodontology.

[38]  Dean Morton,et al.  Consensus statements and recommended clinical procedures regarding loading protocols for endosseous dental implants. , 2004, The International journal of oral & maxillofacial implants.

[39]  F. Kroon,et al.  Immediate loading versus immediate provisionalization of maxillary single-tooth replacements: a prospective randomized study with BioComp implants. , 2006, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[40]  E. Nkenke,et al.  Immediate versus delayed loading of dental implants in the maxillae of minipigs: follow-up of implant stability and implant failures. , 2005, The International journal of oral & maxillofacial implants.

[41]  R. Horowitz.  The use of osteotomes for sinus augmentation at the time of implant placement. , 1997, Compendium of continuing education in dentistry.

[42]  P. Proussaefs,et al.  Effects of immediate loading with threaded hydroxyapatite-coated root-form implants on single premolar replacements: a preliminary report. , 2002, The International journal of oral & maxillofacial implants.

[43]  J. Lindhe,et al.  Bone reactions to longstanding functional load at implants: an experimental study in dogs. , 2005, Journal of clinical periodontology.

[44]  Marcus Abboud,et al.  Immediate loading of single-tooth implants in the posterior region. , 2005, The International journal of oral & maxillofacial implants.