Evaluation of active tactile sensibility in a single-tooth implant opposing a natural tooth with either an immediate or delayed functional loading protocol: A parallel design clinical study

J Prosthet Dent. 2023 Jan 6:S0022-3913(22)00752-1. doi: 10.1016/j.prosdent.2022.11.019. Online ahead of print.

Abstract

Statement of problem: High primary stability makes immediate loading more predictable, but immediately loaded implants are subjected to higher stresses and strains during the healing phase than implants that are left to heal for 3 months. Whether an earlier sensory-motor phenomenon with an immediate loading protocol helps to reduce the risk of overloading at the implant-bone interface is unclear.

Purpose: The purpose of this concurrent parallel design clinical study was to evaluate and compare active tactile sensibility for a single-tooth implant opposing a natural tooth in the mandibular posterior region with either a delayed or immediate functional loading -protocol.

Material and methods: In this parallel group randomized trial, 2 test groups were formed: the DL group comprised 20 participants with the delayed loading protocol (loading after 3 months), and the IL group comprised 20 participants with the immediate loading protocol (loading within 2 days). Natural tooth-to-tooth contact on the side contralateral to the implant site (split mouth) in both test groups was used as a control to evaluate active tactile sensibility, which was evaluated in the test and control sites of both groups by using interocclusal articulating foils of varying thickness in maximum intercuspation. Active tactile sensibility was compared between the DL and IL groups at 3 and 6 months of follow-up. The nonparametric Mann-Whitney test was used for intergroup comparisons (P=.05).

Results: A significant difference was found for 8-μm- and 12-μm-thick articulating foil at 3 months and for 8-μm-thick foil at 6 months (P<.05), indicating a difference in active tactile sensibility between the DL and IL groups. No implant failure was recorded in this short clinical study.

Conclusions: An immediate loading protocol can be performed in implants with sufficient primary stability. Upon loading, the IL group has shown more active tactile perception than the DL group.