Immediate versus one-stage restoration of small-diameter implants for a single missing maxillary lateral incisor: a 3-year randomized clinical trial

J Periodontol. 2009 Sep;80(9):1393-8. doi: 10.1902/jop.2009.090153.

Abstract

Background: The aim of this study was to compare the bone loss pattern and soft tissue healing of immediately versus one-stage loaded 3.0-mm-diameter implants in cases involving a single missing lateral maxillary incisor.

Methods: Sixty patients with a missing lateral incisor in the maxilla were randomized to one of the treatments: 30 patients in the immediate-restoration group and 30 patients in the one-stage group. All implants were placed in healed sites and had to be inserted with a torque >25 Ncm. The implants in the immediate-restoration group were fitted with a non-occluding temporary crown on the day of surgery. Both groups received a full occluding final crown 6 months after surgery. Mean marginal bone loss, probing depth, and bleeding on probing were assessed at 6-, 12-, 24-, and 36-month follow-up examinations by a masked examiner.

Results: Sixty 3.0-mm-diameter implants were placed between July 2003 and February 2006; 27 (45.0%) were in men, and 33 (55.0%) were in women. All implants osseointegrated and were clinically stable at the 6-month follow-up. No statistically significant differences were observed for bleeding or plaque index. No implant fractures occurred. At the 36-month follow-up, the accumulated mean marginal bone loss and probing depth were 0.85 +/- 0.71 mm and 1.91 +/- 0.59 mm, respectively, for the immediate-loading group (n = 30) and 0.75 +/- 0.63 mm and 2.27 +/- 0.81 mm, respectively, for the one-stage group (n = 30). There was no statistically significant difference (P >0.05) for the tested outcome measures between the two procedures.

Conclusions: In the rehabilitation of a single missing lateral maxillary incisor, no statistically significant difference was assessed between immediately and one-stage restored small-diameter implants with regard to implant survival, mean marginal bone loss, and probing depth. Three-millimeter-diameter implants proved to be a predictable treatment option in our test and control groups if a strict clinical protocol was followed.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Alveolar Bone Loss / classification
  • Alveolar Bone Loss / etiology
  • Anodontia / therapy*
  • Crowns
  • Dental Abutments
  • Dental Implantation, Endosseous / methods
  • Dental Implants, Single-Tooth*
  • Dental Plaque Index
  • Dental Prosthesis Design
  • Dental Prosthesis, Implant-Supported*
  • Dental Restoration, Temporary
  • Female
  • Follow-Up Studies
  • Gingival Hemorrhage / classification
  • Humans
  • Incisor / abnormalities*
  • Male
  • Maxilla / surgery
  • Middle Aged
  • Osseointegration / physiology
  • Periodontal Index
  • Periodontal Pocket / classification
  • Treatment Outcome
  • Wound Healing / physiology
  • Young Adult