Immediate loading protocols increase the risk of failure of implants placed by fully guided surgery in partially edentulous jaws: A randomized clinical trial

Clin Implant Dent Relat Res. 2021 Oct;23(5):735-744. doi: 10.1111/cid.13042. Epub 2021 Aug 26.

Abstract

Aim: To compare the 1-year outcomes of immediate loading (IL) and delayed loading (DL) protocols for implants placed by fully guided surgery in partially edentulous jaws.

Materials and methods: This study included 72 patients who received implant surgery with either IL (93 implants, 36 patients) or DL (94 implants, 26 patients). A prefabricated provisional prosthesis was delivered immediately for the IL group (86 implants, 32 patients) with the exception of 4 subjects in whom an initial torque of >20 Ncm and an implant stability quotient of >65 were not achieved, while all DL-group implants were loaded after 3 months. The 1-year implant survival rate estimated by intention-to-treat (ITT) and per-protocol (PP) analyses, and the marginal bone loss (MBL) estimated by cone-beam computed tomography were statistically evaluated (p < 0.05).

Results: The survival rate in the DL group was 100% at both patient and implant levels. With only 26 subjects with 78 implants surviving in the IL group, the survival rates were 69.4% and 83.4% at the patient and implant levels, respectively, in the ITT analysis, and 78.1% and 90.2% in the PP analysis. All intergroup differences in survival rates were statistically significant (p < 0.01). MBL was less than 0.1 mm in both groups (p > 0.05).

Conclusions: IL for implants placed by fully guided surgery in the partially edentulous jaws increased the probability of failure compared to 3-month DL. Regardless of when loading occurred, marginal bone levels remained stable.

Keywords: fully guided implant surgery; implant survival rate; loading of dental implant; marginal bone level; randomized clinical trial.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Alveolar Bone Loss* / etiology
  • Dental Implantation, Endosseous
  • Dental Implants*
  • Dental Prosthesis, Implant-Supported
  • Dental Restoration Failure
  • Humans
  • Immediate Dental Implant Loading*
  • Jaw, Edentulous* / surgery
  • Treatment Outcome

Substances

  • Dental Implants