Immediate Vs. Early Loading of Bone Level Tapered Dental Implants with Hydrophilic Surface in Fully Edentulous Maxilla:Clinical and Patient-Centered Outcomes

2021 ◽  
Author(s):  
Aleksa Markovic ◽  
Tijana Mišić ◽  
Bojan Janjić ◽  
Miodrag Šćepanović ◽  
Branka Trifković ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Oral Health ◽  
Health Impact ◽  
Immediate Loading ◽  
Controlled Clinical Trial ◽  
Insertion Torque ◽  
Implant Stability ◽  
Disability Score ◽  
Early Loading ◽  
Clinical Scenarios

ABSTRACT  The aim was to: (i) compare changes among primary and secondary implant stability between immediate and early loaded implants in edentulous maxilla, (ii) evaluate oral health related quality of life (OHRQoL) and (iii) determine patient satisfaction with 6-implant supported fixed full-arch dentures. A prospective, randomized controlled clinical trial was conducted on 24 edentulous maxilla patients. The BLT SLActive® implants in 12 patients were immediately loaded with temporary restorations while12 patients did not receive temporary restorations. Definitive (final) dentures were delivered to all patients after 6 weeks. Stability of the implants were assessed by Insertion Torque (IT) and Resonance Frequency Analysis (RFA). Oral Health Impact Profile-19 ( OHIP-19) questionnaire was used to evaluate OHRQoL and a Visual Analogue Scale (VAS) for patient satisfaction. The IT value of implants assigned for immediate and early loading group was 27.17±9.55Ncm and 25.01±11.06Ncm, respectively. Changes in implant stability from baseline to week 6 were similar in both groups when measured by Penguin ® (p=0.881) and Ostell ® (p= 0.828).  Patients in the immediate load group reported significantly lower OHIP physical pain scores (p=0.016),  OHIP psychological disability score (p=0.046) and significantly higher VAS function score (p=0.009) and VAS aesthetics score (p=0.009). Implant loading protocols don’t have a significant effect on the change in implant stability 6 weeks after implantation, however, immediate loading significantly improves OHRQoL and satisfaction of patients with maxillary edentulism treated by fixed full-arch dentures. Future trials will determine the role of immediate loading protocol in clinical scenarios with various amounts of available jaw bone using different numbers of implants to retain a fixed prosthetic restoration in the edentulous maxilla.

Patient satisfaction and comfort after a full-arch immediate loaded prosthesis

2020 ◽  
Author(s):  
Elena Dellepiane ◽  
Francesco Pera ◽  
Paola Zunino ◽  
Maria Grazia Mugno ◽  
Paolo Pesce ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Intermediate Phase ◽  
Critical Issue ◽  
Health Impact ◽  
Immediate Loading ◽  
Oral Rehabilitation ◽  
Masticatory Ability ◽  
Chewing Ability

The aim of this study was to assess oral health related quality of life (OHRQoL) of patients before, during and after completion of implant-supported full-arch immediate loading rehabilitation according to the Columbus Bridge Protocol (CBP). 25 patients with compromised dentition were rehabilitated according to the CBP and were assessed for OHRQoL using 4 questionnaires specifically realized for this study and inspired to the OHIP (Oral Health Impact Profile) questionnaire. Patients assessed themselves before surgery, during the healing period (1 week and 2 months after surgery) and after definitive prosthodontic treatment (4 months after surgery). The questionnaires specifically investigated patients’ pain, confort, home oral hygiene habits, satisfaction related to esthetics, masticatory ability, phonetics and general satisfaction toward the treatment.Patients reported an improvement of OHRQoL after full-arch immediate loading rehabilitation. A statistically significant improvement in aesthetic and chewing ability was found. After 4 months 92% of the patients did not feel tense with their smile, 96% did not show problems to relate with other people or smiling, 92% did not show difficulty to eat some foods. Phonetics was found to be a critical issue, especially in the intermediate phase of healing. One week after surgery the percentage of patients who was very satisfied with phonetics slightly decreased from 48% to 36%. The assessment of patients' OHRQoL related to full-arch immediate loading implant therapy exhibited a significant improvement of their quality of life. The questionnaires herein presented could be an effective tool to evaluate patients' reaction to oral rehabilitation.

scholarly journals Primary Stability Optimization by Using Fixtures with Different Thread Depth According To Bone Density: A Clinical Prospective Study on Early Loaded Implants

Materials ◽  
2019 ◽  
Vol 12 (15) ◽  
pp. 2398 ◽  
Author(s):  
Christian Makary ◽  
Abdallah Menhall ◽  
Carole Zammarie ◽  
Teresa Lombardi ◽  
Seung Yeup Lee ◽  
...  
Keyword(s):  
Bone Density ◽  
Primary Stability ◽  
Stability Loss ◽  
Insertion Torque ◽  
Implant Stability ◽  
Marginal Bone Loss ◽  
Early Loading ◽  
Bone Level ◽  
Implant Therapy ◽  
Provisional Restoration

Background: Macro- and micro-geometry are among the factors influencing implant stability and potentially determining loading protocol. The purpose of this study was to test a protocol for early loading by controlling implant stability with the selection of fixtures with different thread depth according to the bone density of the implant site. Materials and Methods: Patients needing implant therapy for fixed prosthetic rehabilitation were treated by inserting fixtures with four different thread diameters, selected based on clinical assessment of bone quality at placement (D1, D2, D3, and D4, according to Misch classification). Final insertion torque (IT) and implant stability quotient (ISQ) were recorded at baseline and ISQ measurements repeated after one, two, three, and four weeks. At the three-week measurement (four weeks after implant replacement), implants with ISQ > 70 Ncm were functionally loaded with provisional restorations. Marginal bone level was radiographically measured 12 months after implant insertion. Results: Fourteen patients were treated with the insertion of forty implants: Among them, 39 implants showing ISQ > 70 after 3 weeks of healing were loaded with provisional restoration. Mean IT value was 82.3 ± 33.2 Ncm and varied between the four different types of bone (107.2 ± 35.6 Ncm, 74.7 ± 14.0 Ncm, 76.5 ± 31.1 Ncm, and 55.2 ± 22.6 Ncm in D1, D2, D3, and D4 bone, respectively). Results showed significant differences except between D2 and D3 bone types. Mean ISQ at baseline was 79.3 ± 4.3 and values in D1, D2, D3, and D4 bone were 81.9 ± 2.0, 81.1 ± 1.0, 78.3 ± 3.7, and 73.2 ± 4.9, respectively. Results showed significant differences except between D1 and D2 bone types. IT and ISQ showed a significant positive correlation when analyzing the entire sample (p = 0.0002) and D4 bone type (p = 0.0008). The correlation between IT and ISQ was not significant when considering D1, D2, and D3 types (p = 0.28; p = 0.31; p = 0.16, respectively). ISQ values showed a slight drop at three weeks for D1, D2, and D3 bone while remaining almost unchanged in D4 bone. At 12-month follow-up, all implants (39 early loading, 1 conventional loading) had satisfactory function, showing an average marginal bone loss of 0.12 ± 0.12 mm, when compared to baseline levels. Conclusion: Matching implant macro-geometry to bone density can lead to adequate implant stability both in hard and soft bone. High primary stability and limited implant stability loss during the first month of healing could allow the application of early loading protocols with predictable clinical outcomes.

scholarly journals Effects of Different Undersizing Site Preparations on Implant Stability

2020 ◽  
Vol 17 (23) ◽  
pp. 8965
Author(s):  
Bernardo Ferreira Lemos ◽  
Paula Lopez-Jarana ◽  
Carlos Falcao ◽  
Blanca Ríos-Carrasco ◽  
Javier Gil ◽  
...  
Keyword(s):  
Primary Stability ◽  
Immediate Loading ◽  
Insertion Torque ◽  
Bovine Bone ◽  
Preparation Technique ◽  
Standard Protocol ◽  
Implant Stability ◽  
Implant Stability Quotient ◽  
Surgical Preparation ◽  
Implant System

As immediate loading protocols are becoming more frequent, the primary stability of implants has become an essential criterion for the osseointegration of dental implants. Based on this, the objective of this study was to understand the influence of different undersized surgical preparation sites on the insertion torque (IT) and implant stability quotient (ISQ). Four different site-preparation protocols were performed on fresh humid type III bovine bone: one control, the standard protocol recommended by the manufacturer (P1), and three variations of undersized techniques (P2, P3 and P4). The implant used was VEGA by Klockner Implant System. The sample size was n = 40 for each of the four groups. A torquemeter was used to measure the IT, and the ISQ was measured with a Penguin RFA. Both variables showed a tendency to increase as the preparation technique was reduced, although not all the values were statistically significant (p < 0.05) when comparing with the standard preparation. The preparations without a cortical drill, P2 and P4, showed better results than those with a cortical drill. Given the limitations of this study, it can be concluded that reducing the implant preparation can increase both the IT and ISQ. Removing the cortical drill is an effective method for increasing implant stability, although it should be used carefully.

Immediate and Early Loading of Hydrothermally Treated, Hydroxyapatite-Coated Dental Implants: 2-Year Results from a Prospective Clinical Study

2016 ◽  
Vol 42 (1) ◽  
pp. 17-25 ◽  
Author(s):  
David E. Simmons ◽  
Archontia Palaiologou ◽  
Austin G. Teitelbaum ◽  
Susan Billiot ◽  
Lomesh J. Popat ◽  
...  
Keyword(s):  
Tactile Feedback ◽  
Prospective Clinical Study ◽  
Insertion Torque ◽  
Implant Stability ◽  
Implant Placement ◽  
Early Loading ◽  
Group A ◽  
Bone Level ◽  
Group B ◽  
Plasma Sprayed

This investigation was undertaken to determine if multithreaded implants partially coated with plasma-sprayed hydroxyapatite (HA) could be effectively loaded earlier than 3–6 months after placement. Forty-eight patients (22 men, 26 women) were enrolled in the study and received 48 implants. The population was divided into 2 groups: A implants (n = 23) were loaded immediately on the day of surgery and group B implants (n = 19) were loaded 3 weeks after surgery. Cone beam computerized tomography (CBCT) scans were taken preoperatively to aid in treatment planning. Bone density was evaluated by tactile feedback during surgery. Insertion torque was recorded at time of implant placement. Resonance frequency analysis, performed on the day of surgery, at the time of loading, and at 6, 12, and 24 months, was used to record implant stability according to the unit's implant stability quotient (Osstell ISQ). Standardized radiographs were taken at time of implant placement and at 6, 12, and 24 months to measure crestal bone stability. Bone level changes were measured by software (Image J). Bone quality was judged as either type 1 (n = 1), 2 (n = 31), 3 (n = 15), or 4 (n = 1). There were no failures in the group A (survival = 100%, n = 23/23) and 1 failure in group B (survival = 94.7%, n = 18/19). After 2 years in function, cumulative mean radiographic bone loss was 0.75 ± 0.50mm (maxillae: 0.92 ± 0.49 mm, n = 14; mandibles: 0.67 ± 0.49 mm, n = 28). No differences in bone levels were noted between implants placed in previously augmented and nonaugmented sites, and there were no periodontal or soft tissue complications. After 2 years in function, implants partially coated with plasma-sprayed and hydrothermally treated HA were clinically predictable when restored in occlusion immediately after or within 3 weeks of implant placement.

scholarly journals Early Loading of Mandibular Molar Single Implants: 1 Year Results of a Randomized Controlled Clinical Trial

Materials ◽  
2020 ◽  
Vol 13 (18) ◽  
pp. 3912 ◽  
Author(s):  
Jungwon Lee ◽  
Young-Jun Lim ◽  
Bongju Kim ◽  
Ki-Tae Koo
Keyword(s):  
Soft Tissue ◽  
Computer Aided Design ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Insertion Torque ◽  
Early Loading ◽  
Mandibular Molar ◽  
Computer Aided ◽  
Bone Level

The purpose of this study was to compare the implant survival, peri-implant marginal bone level, and peri-implant soft tissue of three different types of implants. This was performed with an early loading protocol, using a complete digital workflow, for one year of follow-up. Twenty-four patients with a single missing tooth in the mandibular posterior region were randomly assigned to the control group (SLActive Bone level implant; Institut Straumann AG, Basel, Switzerland), experiment group 1 (CMI IS-III Active implant; Neobiotech Co., Seoul, Korea), and experiment group 2 (CMI IS-III HActive implant; Neobiotech Co., Seoul, Korea). For each patient, a single implant was installed using the surgical template, and all prostheses were fabricated using a computer-aided design/computer-aided manufacturing system on a 3-dimensional model. A provisional prosthesis was implanted at 4 weeks, and a definitive monolithic zirconia prosthesis was substituted 12 weeks following the implant placement. The implant stability quotient (ISQ) and peri-implant soft tissue parameters were measured, and periapical radiographs were taken at 1, 3, 4, 8, 12, 24, 36, and 48 weeks after implant placements. Seven implants in the control group, nine implants in the experiment 1 group, and eight implants in the experiment 2 group were analyzed. There were no significant differences among the three groups in terms of insertion torque, ISQ values between surgery and 8 weeks of follow-up, marginal bone loss at 48 weeks of follow-up, and peri-implant soft tissue parameters (P > 0.05). Statistically significant differences in ISQ values were observed between the control and experiment 1 groups, and the control and experiment 2 groups at the 12 to 48 weeks’ follow-ups. Within the limits of this prospective study, an early loading protocol can be applied as a predictable treatment modality in posterior mandibular single missing restorations, achieving proper primary stability.

scholarly journals Patient-Reported and Clinical Outcomes of Implant-Supported Fixed Complete Dental Prostheses: A Comparison of Metal-Acrylic, Milled Zirconia, and Retrievable Crown Prostheses

2018 ◽  
Vol 44 (1) ◽  
pp. 51-61 ◽  
Author(s):  
Virginia Hogsett Box ◽  
Cortino Sukotjo ◽  
Kent L. Knoernschild ◽  
Stephen D. Campbell ◽  
Fatemeh S. Afshari
Keyword(s):  
Patient Satisfaction ◽  
Oral Health ◽  
Patient Reported Outcomes ◽  
Tooth Wear ◽  
Health Impact ◽  
Complication Rates ◽  
Dental Prostheses ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related

The purpose of this retrospective study was to assess the incidence of biologic and technical complications for implant-supported fixed complete dental prostheses (IFCDPs) and their relationship to oral health-related quality of life (OHQoL) and patient-reported outcomes. Metal-acrylic (MA), retrievable crown (RC), monolithic zirconia (MZ), and porcelain veneered zirconia (PVZ) prostheses were included. Patients who received an IFCDP at least 1 year prior to recall were identified. Exclusion criteria were: (1) an opposing complete denture and (2) time in service &gt;70 months. A total of 37 patients with 49 prostheses, including 22 MA, 14 RC, 7 MZ, and 6 PVZ prostheses were recalled. Patient-reported outcomes were assessed via OHIP-49 (Oral Health Impact Profile) and a scripted interview with open-ended questions. All designs had high complication rates (12 of 22 MA, 10 of 14 RC, 2 of 7 MZ, and 5 of 6 PVZ). The most common complications were: (1) MA: posterior tooth wear, (2) RC: chipping and fracturing of the restorations, (3) MZ: wear of opposing restorations, and (4) PVZ: chipping of opposing restorations. Average OHIP-49 scores ranged from 7 to 29, indicating high OHQoL, patient satisfaction, regardless of prosthetic design (P = .16). The standardized interview highlighted that although most patients were extremely satisfied (73%), some continued to be bothered by material bulk (14%) and felt that maintenance of oral hygiene was excessively time-consuming (16%). In the context of this study, despite high complication rates and maintenance needs, all IFCDP designs resulted in high OHQoL and patient satisfaction.

scholarly journals A Simplified Prosthetic Implant Loading Protocol: 1-Year Clinical Follow-Up Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Lorenzo Andreatta ◽  
Malin Bjursten Brailsford ◽  
Jakob Zwaan
Keyword(s):  
Bone Remodeling ◽  
Treatment Time ◽  
Treatment Protocol ◽  
Immediate Loading ◽  
Insertion Torque ◽  
Implant Stability ◽  
Implant Placement ◽  
Significant Difference ◽  
One Year

Purpose. To retrospectively investigate the one-year clinical outcome following a standardized treatment protocol for immediate loading. The protocol mandates predefined requirements for implant stability. If fulfilled, immediate loading of the implants is performed with a simplified prosthetic protocol which includes one-time impression at the time of surgery and definitive restoration within eight weeks. Methods. Twenty-five patients were treated with 48 Neoss ProActive Tapered implants. Minimum primary stability was established before subjecting the implants to immediate nonfunctional load. Definitive prostheses were delivered six to eight weeks from implant placement. Insertion torque (IT), resonance frequency analysis (RFA), intraoral radiographs, and impressions of implant positions were registered at implant placement. During clinical follow-up, RFA was measured at two, four, and six to eight weeks and six months from implant placement to monitor continued implant stability. Marginal bone level measurements were performed at implant placement, six-month, and one-year follow-up visits. Results. IT was over 40 N·cm for 46 implants. Two implants with IT <30 N·cm were both splinted to another implant with IT >50 N·cm, tightening the retention screw with low forces. No implants were lost during the observation period. Mean RFA measurements remained stable without any decrease during the initial six-month healing phase. Mean marginal bone remodeling was −0.47 ± 0.38 mm from implant placement to 1 year. No significant difference was found for marginal bone remodeling between implants placed in the healed bone or fresh extraction sockets. Conclusion. Within the limits of this study, it is concluded that using a simplified immediate loading protocol can be predictably applied to reduce the overall treatment time and the number of clinical sessions.

scholarly journals A Retrospective Study on Insertion Torque and Implant Stability Quotient (ISQ) as Stability Parameters for Immediate Loading of Implants in Fresh Extraction Sockets

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Giuseppe Bavetta ◽  
Giorgio Bavetta ◽  
Valentina Randazzo ◽  
Alessio Cavataio ◽  
Carlo Paderni ◽  
...  
Keyword(s):  
Test Group ◽  
Immediate Loading ◽  
Control Group ◽  
Insertion Torque ◽  
Implant Stability ◽  
Stability Parameters ◽  
Mean Values ◽  
Implant Stability Quotient ◽  
Significant Difference ◽  
Best Parameter

Background. To date, insertion torque value (ITV) and implant stability quotient (ISQ) obtained by the Osstell instrument are common clinical methods to assess the initial stability of an implant for a predictable loading procedure. The aim of this current study is to evaluate the ITV and ISQ as stability parameters as part of the decision-making protocol in the adoption of immediate loading in fresh extraction sockets. Materials and Methods. A total of 41 tapered implants were allocated into two groups: the test group (n = 11; 3 males and 8 females; mean age: 62.8 ± 10.7) which received 18 implants as type 1 fresh extraction sockets after teeth removal and the control group (n = 7; 4 males and 3 females; mean age: 65.4 ± 9.7) which received 23 implants placed in healed sockets for a period of at least 3 months. Both the ITV and ISQ data were recorded at the time of insertion (t0). Since ITV (test group) and ITV/ISQ (control group) values were useful for the immediate loading protocol, a screw-retained temporary crown was immediately loaded. ISQ values were recorded after a healing period of 4 months (t1). Results. ITV mean values at t0 in test and control groups were, respectively, 48.61 ± 15.39 and 70.47 ± 14.71, whereas ISQ mean values were 57.55 ± 1.93 and 72.86 ± 5.25, respectively, showing a statistically significant difference (p value < 0.001). ISQ mean values at t1 in either the test or the control group were 68.68 ± 4.20 and 74.54 ± 4.17, not showing a statistical difference. The implant survival rate was 100% in both groups, and no surgical and prosthetic complications were reported during the study. Conclusion. In conclusion, this study remarked the presence of a residual gap that influenced the ISQ during implant insertion in fresh extraction sockets making this parameter not sufficient for a conclusive decision in the immediate loading, whereas the ITV alone showed to be the best parameter for a final substantial decision.

scholarly journals Implant Stability in the Posterior Maxilla: A Controlled Clinical Trial

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Raquel Zita Gomes ◽  
Mario Ramalho de Vasconcelos ◽  
Isabel Maria Lopes Guerra ◽  
Rute Alexandra Borges de Almeida ◽  
Antonio Cabral de Campos Felino
Keyword(s):  
Primary Stability ◽  
Controlled Clinical Trial ◽  
Insertion Torque ◽  
Success Rates ◽  
Implant Stability ◽  
Native Bone ◽  
Posterior Maxilla ◽  
Group A ◽  
Group B ◽  
Secondary Stability

Aim. To evaluate the primary and secondary stability of implants in the posterior maxilla. Methods. Patients were allocated into three groups: (A) native bone, (B) partially regenerated bone, and (C) nearly totally regenerated bone. Insertion torque (IT) and implant stability quotient (ISQ) were measured at placement, to evaluate whether satisfactory high primary stability (IT ≥ 45 N/cm; ISQ ≥ 60) was achieved; ISQ was measured 15, 30, 45, and 60 days after placement, to investigate the evolution to secondary stability. Results. 133 implants (Anyridge®, Megagen) were installed in 59 patients: 55 fixtures were placed in Group A, 57 in Group B, and 21 in Group C. Fifty-two implants had satisfactory high primary stability (IT ≥ 45 N/cm; ISQ ≥ 60). A positive correlation was found between all variables (IT, ISQ at t = 0, t = 60), and statistically higher IT and ISQ values were found for implants with satisfactory high primary stability. Significant differences were found for IT and ISQ between the groups (A, B, and C); however, no drops were reported in the median ISQ values during the healing period. Conclusions. The evaluation of the primary and secondary implant stability may contribute to higher implant survival/success rates in critical areas, such as the regenerated posterior maxilla. The present study is registered in the ISRCTN registry with ID ISRCTN33469250.

Pilot Study in the Identification of Stability Values for Determining Immediate and Early Loading of Implants

2007 ◽  
Vol 33 (1) ◽  
pp. 13-22 ◽  
Author(s):  
Tatsuo Shiigai
Keyword(s):  
Pilot Study ◽  
Small Sample Size ◽  
Small Sample ◽  
Insertion Torque ◽  
Implant Survival ◽  
Implant Stability ◽  
Early Loading ◽  
Implant Loading ◽  
The Impact

Abstract This pilot study assessed the impact of implant stability criteria on implant loading time. Insertion torque (IT) and baseline implant stability quotients (ISQ) from resonance frequency analysis were recorded for 41 tapered-screw implants placed in the mandibles of 20 patients. Immediate (IL), early (EL) (6 weeks postoperative), or delayed (DL) (12 weeks postoperative) prosthetic loading was performed based on results and study criteria. Postoperative ISQ values were also recorded at 6 time intervals for the IL and EL groups and after healing for the DL group. All implants were definitively restored after 6 weeks of provisionalization. There were no failures, complications, or stability differences based on loading time. At week 12 of follow-up, ISQ values were slightly higher for IL implants compared with EL implants. IL and EL implants showed significantly higher cumulative ISQ values compared with DL implants. High IT and baseline ISQ values in all groups corresponded to high implant survival. Postoperative ISQ values in the IL and EL groups were less certain indicators of implant survival because of fluctuations relative to baseline values. Small sample size and inequitable patient distribution across groups skewed results. More research is needed before definitive results can be drawn. IL and EL were safely performed within the IT and ISQ ranges in this study, but it is unknown whether EL criteria would have also sufficed for IL.

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