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Interventions for replacing missing teeth: different times for loading dental implants.

M Esposito1, H V Worthington, P Coulthard

  • 1Department of Biomaterials and Department of Prosthetic Dentistry/Dental Material Sciences, The Sahlgrenska Academy at Goteborg University, PO Box 412, Medicinaregatan 8B, Goteborg, Sweden, SE-40530. marco.esposito@biomaterials.gu.se

The Cochrane Database of Systematic Reviews
|January 22, 2003
PubMed
Summary
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Immediate and early loading of osseointegrated oral implants show similar success rates to conventional loading. Further research is needed to confirm predictability, with a focus on immediate loading effectiveness.

Area of Science:

  • Oral and Maxillofacial Surgery
  • Biomaterials Science
  • Clinical Dentistry

Background:

  • Conventionally, osseointegrated oral implants are kept load-free during healing to prevent failure.
  • Removable prostheses used during healing can be uncomfortable for patients.
  • Immediate and early loading protocols are increasingly used in mandibles with good bone quality.

Purpose of the Study:

  • To compare the clinical performance of osseointegrated implants loaded at different times.
  • To test the null hypothesis of no difference in clinical outcomes between immediate, early, and conventional loading of oral implants one year post-loading.

Main Methods:

  • A systematic review of randomized controlled trials (RCTs) was conducted.
  • Searches included major databases (Cochrane, MEDLINE, EMBASE) and handsearching of dental journals.

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  • Two independent reviewers extracted data, assessed quality, and contacted authors for unpublished data.

    • Main Results:

    • Two RCTs involving 68 patients were included, comparing immediate (2-3 days), early (6 weeks), and conventional (3-8 months) loading.
    • No statistically significant differences were found in prosthesis failures, implant failures, or marginal bone loss between the loading groups on a per-patient basis.
    • The study focused on implants in edentulous mandibles with adequate bone quality and shape.

    Conclusions:

    • Immediate loading of oral implants in selected patients with adequate mandibular bone is feasible.
    • The predictability of immediate and early loading protocols requires further investigation through well-designed RCTs.
    • Future research should prioritize trials on immediately loaded implants and adhere to CONSORT guidelines for reporting.