A modified method of immediate loading using Brånemark implants in edentulous mandibles

According to the original protocol, Brånemark implants require a two-step surgical procedure in order to become osseointegrated. The two-stage surgery is sometimes uncomfortable for the patient, and recent research has shown that osseointegration can also be achieved with a one-stage technique with early or immediate loading of the implants in good quality bone, which simplifies and shortens treatment for the patient's benefit. The aim of this study was to evaluate the immediate loading of Brånemark implants with a screw-retained prosthesis in edentulous mandibles. Forty-three patients each had three Brånemark implants of varying lengths and diameters installed in the inter-foramina mandibular area. The implant installation procedures were performed according to the standard protocol with avoidance of over-preparation of the implant sites. The prosthesis framework was prefabricated in advance and was cast and separated into three parts, followed by adjustment in the mouth, with a soldering, impression made in situ; finally, the framework was sent to the laboratory for completion of the bridge. The fixed implant bridge was usually delivered to the patient later the same day. Three of the 129 implants failed to osseointegrate, yielding a success rate of 97.6%, with a follow-up period ranging from 3 to 49 months. The results obtained in this study were encouraging, and thus far this modified method of immediate loading in the anterior edentulous mandible appears to be predictable.