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Early functional loading of unsplinted roughened surface implants with mandibular overdentures 2 weeks after surgery
Alan G T Payne1, Andrew Tawse-Smith, W Murray Thompson
1Department of Oral Rehabilitation, School of Dentistry, PO Box 647, University of Otago, Dunedin, New Zealand. alan.payne@dent.otago.ac.nz
Background:
Before early functional loading of unsplinted implants with mandibular overdentures can become widespread, more clinical studies are needed to investigate the success of the approach.
Purpose:
To evaluate the success rates of two types of roughened titanium surface implants with early 2-week functional loading of paired mandibular interforaminal implants with overdentures.
Materials And Methods:
Random allocation divided 24 strictly selected edentulous participants into two groups, with each group to receive a different implant system (ITI Dental Implant System, Straumann AG, Waldenburg, Switzerland; or Southern Implant System, Southern Implants, Irene, South Africa). Two implants were placed in the anterior mandible of all participants using one-stage standardized surgical procedures. Previously constructed conventional mandibular dentures (opposing maxillary complete dentures) were temporarily relined and worn by the participants for the first 2 weeks; participants used a soft diet. Two weeks after implant surgery and following some mucosal healing, the mandibular dentures had the tissue conditioner removed and the appropriate matrices included for an unsplinted prosthodontic design.
Results:
No implant from either group was lost. Resonance frequency analysis (RFA) indicated higher primary stability at surgery for the Southern group than for the ITI group, with a statistically significant difference between the groups throughout the study period. The drop in RF values between surgery and 6 weeks was significant and was greater for the Southern group. RFA also indicated stabilized osseointegration between 6 to 12 and 12 to 52 weeks, with no participant showing any decrease in those values over time. Participants with type 3 bone showed a significant improvement in RF values between 12 and 52 weeks, eventually matching those of participants with type 2 bone. There were no significant differences in marginal bone loss, periimplant parameters, or prosthodontic maintenance between the groups over the study period.
Conclusions:
Using only strict patient selection criteria, 1-year follow-up data indicate that early functional loading of ITI and Southern implants with mandibular two-implant overdentures is possible as early as 2 weeks after implant surgery.