Immediate Loading of Dental Implants Inserted in Edentulous Maxillas and Mandibles: 5-Year Results of a Clinical Study
The aim of the present study was to evaluate the long-term outcome of immediately loaded full-arch, fixed, one-piece prostheses supported by dental implants inserted in completely edentulous maxillae and mandibles. Twenty-eight completely edentulous jaws in 27 patients were treated with screw-fixed provisional prostheses on the same day as implant insertion. A total of 189 implants were inserted into the jaws of the patients. All provisional prostheses were the one-piece bridge type and were made with acrylic resin. Final restoration was performed more than 2 months after surgery. Implant survival rate, prosthesis success rate, and complications during the follow-up period were evaluated. Implant size (diameter and length) and bone quality (Hounsfield units) of the region of the implant were also analyzed. Mean follow-up time was 77.9 months. The cumulative survival rate of the implants was 100%, and the success rate of the prostheses was also 100% during the observation time. Although 3 types of minor complications occurred in 10 jaws (10/28; 35.7%), no major complications were found. Immediate loading of dental implants produces an equivalent outcome as that reported in previous studies using conventional loading. We believe this study not only adds to the immediate loading data but also confirms that the immediate loading technique may be most advantageous strategy for edentulous patients.
Four typical cases of edentulousness are shown. Two (a and b) are maxilla and others (c and d) are mandible cases. (a) A 66-year-old man. Ten implants were inserted symmetrically in the maxilla because bone condition was good at each side of maxilla. (b) A 58-year-old woman. Six implants were inserted with tilting to avoid perforating the maxillary sinuses. One implant was added at right first molar region to avoid a long cantilever. (c and d) A common strategy in our procedure was to place 4 or 6 implants between foramens in the mandible. (c) A 67-year-old woman. Six implants were inserted between foramens. (d) A 55-year-old man. Six implants were inserted between foramens, in the same way as for (c), and 2 short implants were added to avoid injuring the inferior alveolar nerves.
Figure 2. A bridge-type provisional restoration was immediately set after implantation in the maxilla (a) and mandible (b). Figure 3. Mean Hounsfield units (HUs) corresponding to the implant position (immediately loaded cases). The highest HU was in the anterior mandible, and the lowest was in the posterior maxilla. Each lesion had a sufficient HU to acquire primary stability after implantation. Figure 4. Breakage of the provisional prosthesis. The arrow indicates the crack in the provisional prosthesis. Fortunately, this had no effect on the implants. The temporary prosthesis was repaired and reset.
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