Paolo Guazzi

Survival and Success Rates of Immediately and Early Loaded Implants: 12-Month Results From a Multicentric Randomized Clinical Study

Our objective was to compare survival and peri-implant bone levels of immediately nonocclusally vs early loaded implants in partially edentulous patients up to 12 months after implant placement. Eighty patients (inclusion criteria: general good health, good oral hygiene, 30-65 years old; exclusion criteria: head and neck irradiation/cancer, pregnancy, uncontrolled diabetes, substance abuse, bruxism, lack of opposing occluding dentition, smokers >10 cigarettes/day, need for bone augmentation procedures) were selected in 5 Italian study centers and randomized into 2 groups: 40 patients in the immediately loaded group (minimal insertion torque 30 Ncm) and 40 patients in the early loaded group. Immediately loaded implants were provided with nonoccluding temporary restorations. Final restorations were provided 2 months later. Early loaded implants were provided with a definitive restoration after 2 months. Peri-implant bone resorption was evaluated radiographically with software (ImageJ 1.42). No dropout occurred. Both groups gradually lost peri-implant bone. After 12 months, patients of both groups lost an average of 0.4 mm of peri-implant bone. There were no statistically significant differences (evaluated with t test) between the 2 loading strategies for peri-implant bone level changes at 2 (P = .6730), 6 (P = .6613) and 12 (P = .5957) months or for survival rates (100% in both groups). If adequate primary stability is achieved, immediate loading of dental implants can provide similar success rates, survival rates, and peri-implant bone resorption as compared with early loading, as evaluated in the present study.

Immediate Loading of Single Post-Extractive Implants in the Anterior Maxilla: 12-Month Results From a Multicenter Clinical Study

The purpose of the study was to evaluate survival and peri-implant bone levels of single, immediately loaded post-extractive implants in the anterior maxilla 12 months after implant placement. Thirty-six consecutive patients from 3 study centers were included in the study. The concerned sites were upper premolars, canines, and incisors. For each patient the following data were recorded: reason for tooth extraction, bone quality, implant size, and final insertion torque. Implants were placed using a flapless technique and immediately loaded with a nonoccluding temporary restoration. Final restorations were provided 4 months later. Peri-implant bone resorption was evaluated radiographically after 6 and 12 months. The average final insertion torque was 70.55 Ncm. One implant inserted in D3 quality bone with a 35-Ncm seating torque was lost. All other implants had a final insertion torque ranging between 50 and 80 Ncm. The average peri-implant bone loss was 0.437 and 0.507 mm at 6 and 12 months, respectively. All the sites maintained excellent papillae and peri-implant soft-tissue conditions. The resulting 1-year success rate was 97.2%. Immediate nonfunctional loading of single post-extractive implants in the anterior maxilla is a predictable treatment. And it seems that achieving high insertion torques by placing self-tapping/self-condensing implants in an underprepared osteotomy is favorable.